Abstract

Vascularized Composite Allotransplants (VCA) including hand, face and most recently transplants of reproductive organs represent unique, life changing procedures that have been established in centers around the world, albeit in small numbers [1]. One of the major impediments in moving VCA transplants forward has been the necessity of immunosuppression for a procedure that is life-enhancing rather than lifesaving. Indeed, side-effects of immunosuppression have been broad in VCA, just like in solid organ transplant recipients. Of additional relevance, unwanted effects of immunosuppressants may also reach a different level of concern for a life-long immunosuppression in face and hand transplantation compared to short-term treatments in temporary grafts such as uterine transplants.

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