PMID- 30829423
OWN - NLM
STAT- MEDLINE
DCOM- 20200220
LR  - 20200220
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 32
IP  - 8
DP  - 2019 Aug
TI  - Graft vasculopathy of vascularized composite allografts in humans: a literature 
      review and retrospective study.
PG  - 831-838
LID - 10.1111/tri.13421 [doi]
AB  - Mechanisms of chronic rejection of vascularized composite allografts (VCA) remain 
      poorly understood and likely present along a spectrum of highly varied 
      clinicopathological findings. Across both animal and human VCA however, graft 
      vasculopathy (GV) has been the most consistent pathological finding resulting 
      clinically in irreversible allograft dysfunction and eventual loss. A literature 
      review of all reported clinical VCA cases with documented GV up to December 2018 
      was thus performed to elucidate the possible mechanisms involved. Relevant data 
      extracted include C4d deposition, donor-specific antibody (DSA) formation, extent 
      of human leukocyte antigen (HLA) mismatch, pretransplant panel reactive antibody 
      levels, induction and maintenance immunosuppression used, the number of preceding 
      acute rejection episodes, and time to histological confirmation of GV. 
      Approximately 6% (13 of 205) of all VCA patients reported to date developed GV at 
      a mean of 6 years post-transplantation. 46% of these patients have either lost or 
      had their VCAs removed. Neither C4d nor DSA alone was predictive of GV 
      development; however, when both are present, VCA loss appears inevitable due to 
      progressive GV. Of utmost concern, GV in VCA does not appear to be abrogated by 
      currently available immunosuppressive treatment and is essentially irreversible 
      by the time of diagnosis with allograft loss a likely eventuality.
CI  - (c) 2019 Steunstichting ESOT.
FAU - Ng, Zhi Yang
AU  - Ng ZY
AUID- ORCID: 0000-0003-0538-3066
AD  - Vascularized Composite Allotransplantation Laboratory, Center for Transplantation 
      Sciences, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 
      Boston, MA, USA.
FAU - Lellouch, Alexandre G
AU  - Lellouch AG
AD  - Vascularized Composite Allotransplantation Laboratory, Center for Transplantation 
      Sciences, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 
      Boston, MA, USA.
AD  - Service de Chirurgie Plastique, Hopital Europeen Georges Pompidou, Assistance 
      Publique-Hopitaux de Paris (APHP), Universite Paris Descartes, Paris, France.
FAU - Rosales, Ivy A
AU  - Rosales IA
AD  - Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
FAU - Geoghegan, Luke
AU  - Geoghegan L
AD  - Vascularized Composite Allotransplantation Laboratory, Center for Transplantation 
      Sciences, Massachusetts General Hospital, Boston, MA, USA.
FAU - Gama, Amon-Ra
AU  - Gama AR
AD  - Vascularized Composite Allotransplantation Laboratory, Center for Transplantation 
      Sciences, Massachusetts General Hospital, Boston, MA, USA.
FAU - Colvin, Robert B
AU  - Colvin RB
AD  - Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
FAU - Lantieri, Laurent A
AU  - Lantieri LA
AD  - Service de Chirurgie Plastique, Hopital Europeen Georges Pompidou, Assistance 
      Publique-Hopitaux de Paris (APHP), Universite Paris Descartes, Paris, France.
FAU - Randolph, Mark A
AU  - Randolph MA
AD  - Vascularized Composite Allotransplantation Laboratory, Center for Transplantation 
      Sciences, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 
      Boston, MA, USA.
FAU - Cetrulo, Curtis L Jr
AU  - Cetrulo CL Jr
AD  - Vascularized Composite Allotransplantation Laboratory, Center for Transplantation 
      Sciences, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 
      Boston, MA, USA.
LA  - eng
GR  - W81XWH-13-2-0062/US Department of Defense Reconstructive Transplantation Research 
      Consortium/
PT  - Journal Article
PT  - Review
DEP - 20190402
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Peptide Fragments)
RN  - 0 (Steroids)
RN  - 80295-50-7 (Complement C4b)
RN  - 80295-52-9 (complement C4d)
SB  - IM
MH  - Allografts/immunology
MH  - Antibodies/immunology
MH  - Complement C4b
MH  - Composite Tissue Allografts/*immunology
MH  - Disease Progression
MH  - Follow-Up Studies
MH  - Graft Rejection/*immunology
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Immune Tolerance
MH  - Peptide Fragments/blood
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Steroids/therapeutic use
MH  - Treatment Outcome
MH  - Vascular Diseases/immunology
MH  - Vascularized Composite Allotransplantation/*adverse effects/methods
OTO - NOTNLM
OT  - chronic rejection
OT  - composite tissue allografts
OT  - graft vasculopathy
OT  - vascularized composite allografts
EDAT- 2019/03/05 06:00
MHDA- 2020/02/23 06:00
CRDT- 2019/03/05 06:00
PHST- 2018/12/21 00:00 [received]
PHST- 2019/01/29 00:00 [revised]
PHST- 2019/02/26 00:00 [accepted]
PHST- 2019/03/05 06:00 [pubmed]
PHST- 2020/02/23 06:00 [medline]
PHST- 2019/03/05 06:00 [entrez]
AID - 10.1111/tri.13421 [doi]
PST - ppublish
SO  - Transpl Int. 2019 Aug;32(8):831-838. doi: 10.1111/tri.13421. Epub 2019 Apr 2.