Cellular therapies for prolongation of composite tissue allograft transplantation

Complex musculoskeletal defects resulting from cancer, congenital absence, and trauma represent a unique reconstructive challenge. Autologous tissue is often unavailable to reconstruct these deformities. Composite tissue allograft transplantation represents a unique solution for these clinical problems. Face, hand, or limb transplants can be performed in a single procedure. However, the use of chronic nonspecific systemic immunosuppression can lead to side effects such as drug toxicity; opportunistic infections, and malignancies. This article explores various cell-based therapies that represent promising modalities to reduce chronic immunosuppression and alter the risk/benefit ratios for the prospect of composite tissue allograft transplantation.Univ Pittsburgh, Div Plast & Reconstruct Surg, Dept Surg, Pittsburgh, PA 15261 USAUniversidade Federal de São Paulo, Div Plast Surg, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Div Plast Surg, BR-04023900 São Paulo, BrazilWeb of Scienc