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Transplantation of Composite Tissue Allografts

:	Charles W. Hewitt, W.P. Andrew Lee, C.R. Gordon
:	Charles W. Hewitt, W.P. Andrew Lee
:	Transplantation of Composite Tissue Allografts
:	Springer-Verlag
:	9780387746821
:	1
:	CHF 132.50
:

:	Nichtklinische Fächer
:	English

:	483
:	Wasserzeichen
:	PC/MAC/eReader/Tablet
:	PDF

This brilliant synthesis summarizes all of the recent accomplishments - as well as the ongoing research - in the field of composite tissue transplantation. It includes sections on hand transplantation and vascularized bone marrow transplantation. The volume focuses on immunology and the biotechnology/bioengineering aspects of transplantation surgery, as those two areas have demonstrated the most growth within the last five years in terms of current research.

	Foreword: The Import of Composite Tissue Transplantation	6
	Preface	7
	Contents	8
	Contributors	12
	Section I	18
	The Establishment of Composite Tissue Allotransplantion as a Clinical Reality	19
	1.1 Introduction	19
	The Evolution of Composite Tissue Allotransplantation: the Twentieth Century Realization of “ Cosmas and Damian”	29
	2.1 Historical Background	29
	2.2 Current Status	33
	2.2.1 Trachea	34
	2.2.2 Peripheral Nerve	34
	2.2.3 Flexor Tendon Apparatus	35
	2.2.4 Vascularized Knee	35
	2.2.5 Lower Extremity	36
	2.2.6 Larynx	36
	2.2.7 Abdominal Wall	36
	2.2.8 Partial Face	37
	2.2.9 Complete Face/Scalp	37
	References	38
	The Impact of the Discovery of Cyclosporine on Transplantation of Composite Tissue Allografts	42
	3.1 Introduction	42
	3.2 History of Composite Transplantation	42
	3.3 Immunosuppression	43
	3.4 Cyclosporine: Discovery and Structure	44
	3.5 Cyclosporine: Mechanism of Action	46
	3.6 Biologic Effects of Cyclosporine	46
	References	48
	The First Limb Transplants with Cyclosporine	52
	4.1 Introduction	52
	4.2 The Questions	52
	4.3 Materials and Methods	53
	4.4 Cyclosporine and Limb Transplants	54
	4.5 The Return of Cosmas and Damian	54
	References	55
	Section II	56
	Translational Research in Composite Tissue Allotransplantation	57
	5.1 Introduction	57
	5.2 Classification of Human Skin Rejection in CTA	58
	5.3 Development of a Nonhuman Primate Model for the Study of CTA	60
	5.3.1 Postoperative Management	62
	5.3.2 Results	64
	5.4 Conclusions	65
	References	67
	Relative Antigenicity of Allograft Components and Differential Rejection	69
	6.1 Introduction	69
	6.2 Components of Vascularized Tissue Allograft	70
	6.2.1 Skin	71
	6.2.2 Muscle	74
	6.2.3 Tendon	74
	6.2.4 Cartilage	75
	6.2.5 Bone	75
	6.2.6 Nerve	77
	6.2.7 Vessels	77
	6.3 Discussion	78
	References	80
	On the Road to Tolerance Induction in Composite Tissue Allotransplantation	84
	7.1 Introduction	84
	7.2 T-Cell Tolerance	86
	7.3 Regulatory T Cells	87
	7.4 T Suppressor Cells	88
	7.5 Pharmacologic Induction Strategies	89
	7.6 Costimulation Blockade	89
	7.7 Donor-Specific Transfusions	91
	7.8 T-Cell Activation	91
	7.9 Dendritic Cells	92
	7.10 Microchimerism	94
	7.11 Mixed Chimerism	94
	7.12 Conclusion	95
	References	96
	Donor-Specific Tolerance	102
	8.1 Introduction	102
	8.2 Physiologic Mechanisms of Induction Therapy	103
	8.2.1 T Cells	103
	8.3 Generation of T Regulatory Cells	104
	8.4 T-Cell Costimulatory Blockade	106
	8.5 Donor-Specific Transfusion	108
	8.6 Gene Therapy for Tolerance Induction	109
	8.6.1 Gene Therapy Vectors	110
	8.6.2 Chemokine Antagonists	111
	8.6.3 MHC Molecules	112
	8.6.4 Immunosuppressive Cytokines	112
	8.6.5 Blockage of Costimulatory Signals	113
	8.7 Conclusion	114
	References	114
	Immune Tolerance Induction: Basic Concepts for Composite Tissue Allotransplantation	119
	9.1 The Clinical Problem and Possible Solution	119
	9.2 Immune Tolerance Definition	120
	9.3 Immune Mechanisms Implicated in Tolerance	121
	9.3.1 Central Tolerance	121
	9.3.2 Peripheral Tolerance	122
	9.4 Composite Tissue Allograft Rejection	125
	9.5 Strategies for Tolerance Induction in CTA	126
	References	128
	Section III	132
	Allograft Survival with Calcineurin Inhibitors	133
	10.1 Introduction	133
	10.2 Molecular Action of Calcineurin Inhibitors	133
	10.2.1 Immunosuppression with Calcineurin Inhibitors and Survival of Composite Tissue Allografts in Small Animals	134
	10.2.2 Immunosuppression with Calcineurin Inhibitors and Survival of Composite Tissue Allografts in Large Animals	142
	10.2.3 Clinical Applications of Composite Tissue Transplantation and Immunosuppression with Calcineurin Inhibitors	145
	10.2.4 Short-Term Immunosuppression with Calcineurin Inhibitors and Tolerance Induction in Composite Tissue Allografts	145
	10.3 Future Solutions	156
	References	156
	Long-Term Prevention of Rejection and Combination Drug Therapy	162
	11.1 Introduction	162
	11.2 Combination Drug Therapy	162
	11.3 First Clinical Applications	165
	11.4 Hand Transplantation	167
	11.5 Chronic Rejection	169
	References	171
	Locoregional Immunosuppression in Composite Tissue Allografting	176
	12.1 Introduction	176