New procedure makes limb transplant easier

A new procedure for limb transplant has opened a fresh window for patients suffering from facial injuries or hand/arm amputation.

The key lies in inducing immune tolerance - essentially tricking a recipient's immune system into accepting donor tissue - could be an ideal solution to free patients from lifelong immuno-suppression, said researchers at Massachusetts General Hospital (MGH) in the US.

Patients who undergo limb transplants need suppression of the immune response - via drugs or radiation - in order to prevent the rejection of grafts or transplants.

"The need for lifelong immuno-suppression to prevent graft rejection is the most important challenge. Most potential recipients of what are called vascularised composite allografts (VCAs) are young and would face increased risks of infection, even some types of cancer, over many years," said Curtis L. Cetrulo, head of plastic and reconstructive surgery at MGH and senior author.

VCAs involve transplantation of muscle, bone, skin and nerves to replace amputated hands and arms and to repair severe facial injuries, said the study published in the American Journal of Transplantation.

"Bringing immune tolerance to hand and face transplantation would result in a paradigm shift in the way we treat those injuries. Tolerance would give us a unique tool - a real game changer - with which to help these patients," Cetrulo added.

In several previous attempts to induce VCA tolerance, bone and muscle tissue were accepted but the skin was rejected and eventually separated from the underlying tissue.

"If all goes well, the procedure might be ready for testing in a clinical trial in a year," added Cetrulo.