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Table 1: Current success and challenges in VCA

From: Current status of vascularized composite tissue allotransplantation

Achievements

Challenges

Excellent esthetic and functional outcome

Minimization of immunosuppression, tolerance induction

Multidisciplinary approach

Protocols for sensitized patients

Recognition as organ, regulated by OPTN

Improved monitoring

Excellent patient and graft survival

Mechanisms of rejection Acute cellular and humoral rejection

 

Acute cellular and humoral rejection

 

Chronic graft deterioration

 

Nerve regeneration

 

Definition of acceptable ischemic times

 

Refined organ preservation

  1. VCA = Vascularized composite tissue allotransplantation, OPTN = Organ Procurement and Transplantation Network