About this Research Topic
Vascularized composite allotransplantation (VCA) has emerged as a well-established reconstructive method for treating tissue defects. Worldwide, more and more hand and upper extremity VCAs have been performed successfully, demonstrating short to intermediate-term functional results. Acute rejection is almost invariably seen in VCA, occurring at a rate roughly six times higher than in solid organ transplants.
Optimal immunosuppression is key to maintaining VCA graft survival. To date, systemic administration of single or multiple immunosuppressive drugs, such as CNIs and tacrolimus (TAC), in combination with perioperative induction therapy, is still the standard therapy to prevent graft rejection. However, this approach has a wide range of well-known side effects, such as complications, nephrotoxicity, and opportunistic infections. Targeted and controlled drug delivery systems for immunosuppression present a paradigm shift in managing immune-related disorders, offering distinct advantages over systemic immunosuppression. This research topic aims to delve into recent findings and innovations in localized therapy for allograft rejection in VCA, seeking contributions from both experts and new perspectives. We aim to gather further insights into the advantages and limitations of various strategies while questioning their efficacy.
We welcome various articles (ranging from Original Research to case studies and Opinion Pieces) addressing, but not limited to, the following themes:
1. Comparative Systemic with Local Therapy: Impact on transplantation outcomes, advantages, and disadvantages.
2. Immunological Challenges: Exploration of host immune responses in both approaches.
3. Innovative Techniques: Drug delivery systems that allow for local treatment.
4. Ethical Implications: Consideration of the ethical dilemmas surrounding biomaterials and how these can be addressed.
5. Technological Innovations: Discussions on technological breakthroughs that could influence the future of local therapy.
6. Long-term Consequences: Comparative review of the long-term effects of transplantation in both models, considering both medical and quality of life outcomes.
7. Regulatory Standards and Policies: Assessment of current international transplant regulations regarding these approaches.
By encouraging dialogue between diverse perspectives, we hope to enhance our understanding and shed light on the next steps in research and application.
Optimal immunosuppression is key to maintaining VCA graft survival. To date, systemic administration of single or multiple immunosuppressive drugs, such as CNIs and tacrolimus (TAC), in combination with perioperative induction therapy, is still the standard therapy to prevent graft rejection. However, this approach has a wide range of well-known side effects, such as complications, nephrotoxicity, and opportunistic infections. Targeted and controlled drug delivery systems for immunosuppression present a paradigm shift in managing immune-related disorders, offering distinct advantages over systemic immunosuppression. This research topic aims to delve into recent findings and innovations in localized therapy for allograft rejection in VCA, seeking contributions from both experts and new perspectives. We aim to gather further insights into the advantages and limitations of various strategies while questioning their efficacy.
We welcome various articles (ranging from Original Research to case studies and Opinion Pieces) addressing, but not limited to, the following themes:
1. Comparative Systemic with Local Therapy: Impact on transplantation outcomes, advantages, and disadvantages.
2. Immunological Challenges: Exploration of host immune responses in both approaches.
3. Innovative Techniques: Drug delivery systems that allow for local treatment.
4. Ethical Implications: Consideration of the ethical dilemmas surrounding biomaterials and how these can be addressed.
5. Technological Innovations: Discussions on technological breakthroughs that could influence the future of local therapy.
6. Long-term Consequences: Comparative review of the long-term effects of transplantation in both models, considering both medical and quality of life outcomes.
7. Regulatory Standards and Policies: Assessment of current international transplant regulations regarding these approaches.
By encouraging dialogue between diverse perspectives, we hope to enhance our understanding and shed light on the next steps in research and application.
Keywords: Transplantation, VCA, Allograft, Rejection, Local Therapy
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.
