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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Chris Willmott
Chris Willmott
Portland Press would like to thank Dr Silvia Camporesi (Kings College London) for her input into the initial discussions around some of the concepts covered in this issue of Emerging Topics in Life Sciences, and for securing some of the contributors and content.
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Article Contents
Review Article|
November 14 2019
Upper extremity and craniofacial vascularized composite allotransplantation: ethics and immunosuppression
James Benedict
;
The Center for Healthcare Ethics, Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, U.S.A.
Correspondence: James Benedict (benedictj@duq.edu) or Gerard Magill (magillg@duq.edu)
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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 (benedictj@duq.edu) or Gerard Magill (magillg@duq.edu)
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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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