Psychosocial and Bioethical Challenges and Developments for The Future of Vascularized Composite Allotransplantations

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About this Research Topic

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Background

Vascularized composite allotransplantations (VCA) have moved from being a purely experimental option for few patients to being a standard one. However, this transition has occurred without a detailed, comprehensive, and objective investigation of psychosocial and bioethical factors. The psychosocial and bioethical implications of VCA transplantations are believed to be particularly important, but standardized protocols for the evaluation of these factors are still evolving. The most important development in the field is an emerging recognition that the pre- and post-transplantation psychosocial evaluations and treatments as well as the identification of at-risk patients and those requiring ongoing counselling are an integral part of any transplant VCA program.

Psychosocial factors are important in the assessment and follow-up care for VCA and require multidisciplinary evaluation protocols. The Chauvet workgroup has been convened to address these issues. A multicentred research network would share similar evaluation approaches so that meaningful research on psychosocial variables could inform the transplant community about the psychosocial factors necessary for positive VCA outcomes.

This article collection builds on the work of many researchers and aims to provide a framework of psychosocial and bioethical aspects in the field of vascularized composite allotransplantation (VCA).

With the small number of VCA cases performed at each center, there is a clear need for a multicentered, multinational platform that would bring together various experts and evaluate as many VCA cases as possible. We will describe the relevant psychosocial and bioethical factors important for the formation of such a platform and outline its vision and current projects, based on the international research concept of the Chauvet workgroup.

The Chauvet workgroup will provide an international platform that works in collaboration with international transplantation societies (e.g. The Transplantation Society (TTS), European Society for Organ Transplantation (ESOT), American Society for Reconstructive Transplantation (ASRT), International Society of Vascularized Composite Allotransplantation (ISVCA) ) and brings together all renowned experts in this field.

This article collection will focus on papers that address psychosocial and bioethical aspects of vascularized composite allotransplantation (VCA). The different VCA entities and associated psychosocial issues (e.g. hand, face, and uterus transplantation) as well as bioethical considerations will be discussed. Bioethical considerations support the development of standardized protocols. Furthermore, this Research Topic will demonstrate the need for more collaborative, multicentred research necessary to perform these high-end medical procedures. The Chauvet research concept will be described as a multicentred, multinational platform that brings together expertise and knowledge from as many of the VCA cases performed as possible. Finally, this article collection will identify key issues that should be addressed in future research.

This collection of papers should consist of the following types of manuscripts: review, policy and practice review, perspective, brief research report, and policy brief. Particularly, the submission of original articles would be highly appreciated, presenting recent research innovations in this field, e.g. results of qualitative research initiatives to investigate relevant psychosocial outcome predictors.

Keywords: Psychology; vascularized composite tissue allotransplantation; evaluation; follow-up; multicenter research approach

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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