Vascularized composite allotransplantation (VCA) is the name most often used to refer to the transplantation of anatomical units composed of multiple tissue types (skin, bone, muscle, tendon, nerves, vessels, etc.) when such transplants do not have the primary purpose of extending life, as is the case in the more familiar field of solid organ transplantation (SOT). A serious interest in VCA developed in the late twentieth century following advances in immunosuppression which had led to significant improvements in short and medium-term survival among SOT recipients. Several ethical concerns have been raised about VCA, with many being connected in one way or another to the limitations, burdens, and risks associated with immunosuppression. This article will focus on upper extremity and craniofacial VCA, beginning with a brief review of the history of VCA including reported outcomes, followed by a discussion of the range of ethical concerns, before exploring in greater detail how immunological issues inform and shape several of the ethical concerns.
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November 2019
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Cover Image
Cover Image
This issue's cover features a collection of images to showcase the breadth of topics which raise bioethical questions, many of which are covered in this issue. Image credits (clockwise from top left): andriano. cz/Shutterstock.com; David Parry/PA Wire https://culturedbeef.org/; Peterson and Owen (pages 707–711); Gleadow et al. (pages 723–729).
Review Article|
November 14 2019
Upper extremity and craniofacial vascularized composite allotransplantation: ethics and immunosuppression Available to Purchase
James Benedict;
The Center for Healthcare Ethics, Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, U.S.A.
Correspondence: James Benedict ([email protected]) or Gerard Magill ([email protected])
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Gerard Magill
The Center for Healthcare Ethics, Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, U.S.A.
Correspondence: James Benedict ([email protected]) or Gerard Magill ([email protected])
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Publisher: Portland Press Ltd
Received:
August 07 2019
Revision Received:
October 02 2019
Accepted:
October 14 2019
Online ISSN: 2397-8562
Print ISSN: 2397-8554
© 2019 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society and the Royal Society of Biology
2019
Emerg Top Life Sci (2019) 3 (6): 681–686.
Article history
Received:
August 07 2019
Revision Received:
October 02 2019
Accepted:
October 14 2019
Citation
James Benedict, Gerard Magill; Upper extremity and craniofacial vascularized composite allotransplantation: ethics and immunosuppression. Emerg Top Life Sci 27 November 2019; 3 (6): 681–686. doi: https://doi.org/10.1042/ETLS20190060
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