Exploring cell-based tolerance strategies for hand and face transplantation

Madeline Fryer, Johanna Grahammer, Saami Khalifian, Georg J. Furtmüller, W. P.Andrew Lee, Giorgio Raimondi, Gerald Brandacher

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations


Broader clinical application of reconstructive hand and face transplantation is hindered by the need for lifelong immunosuppression for allograft maintenance. In this review, we summarize various cell-based approaches to tolerance induction currently under investigation in both clinical and pre-clinical models to alleviate the need for chronic immunosuppression. These include strategies to induce mixed hematopoietic chimerism, therapy with T and B regulatory cells, regulatory macrophages, tolerogenic dendritic cells, and mesenchymal stem cells. The vascularized, intragraft bone components inherent to reconstructive transplants serve as a continuous source of donor-derived hematopoietic cells, and make hand and face transplants uniquely well suited for cell-based approaches to tolerance that may ultimately tilt the risk-benefit balance for these life-changing, but not life-saving, procedures.

Original languageEnglish (US)
Pages (from-to)1189-1204
Number of pages16
JournalExpert Review of Clinical Immunology
Issue number11
StatePublished - Nov 2 2015
Externally publishedYes


  • mesenchymal stem cell
  • mixed chimerism
  • regulatory B cell
  • regulatory macrophage
  • regulatory T cell
  • tolerance
  • tolerogenic dendritic cell
  • vascularized composite allotransplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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