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news News Tuesday, March 26, 2019 Tuesday, March 26, 2019 10:01 AM - Tuesday, March 26, 2019 10:01 AM

Study focuses on overcoming organ transplantation challenges

Study focuses on overcoming organ transplantation challenges

Patients with large and deep burns require transplantation of skin flaps and similar vascularized composite allografts (VCAs). At Shriners Hospitals for Children — Boston, researchers are taking a look at various challenges with organ transplantation, specifically those involving VCAs. These challenges include:

  • Logistical factors – VCAs are very sensitive and can only survive for a short duration of time during transport.
  • Organ rejection – VCAs are particularly sensitive to rejection, making donor/recipient matching challenging. This challenge is further heightened since VCAs require matching based on anatomical features like recipient skin tone and size.

Bio-preservation of VCAs can be a powerful solution to the problems outlined above. Principal investigators Korkut Uygun, Ph.D., Curtis Cetrulo, M.D., Mehmet Toner, Ph.D., and Shannon Tessier, Ph.D., are focusing their study on developing new methods to increase the length of time that organs remain alive during transport. Longer storage duration would allow for VCAs to be transported across shorter distances and improve donor/recipient matching. Further, this would allow for more planning time so surgeries would become elective, rather than emergencies. It would also reduce the unnecessary waste of quality organs.

This is especially important for VCAs, which involve the transplantation of multiple structures including skin, bone, muscle, blood vessels and nerves. The most common VCAs are hand and face transplants, while skin flaps offer a promising treatment solution for burn patients. In fact, VCAs typically degrade even faster than some vital organs, and tissues that cannot be salvaged and maintained long enough are frequently discarded because of poor long-term functional outcomes. Also, VCA transplants need to be matched based on specific anatomical features including size, gender and skin color, in addition to immunological ones, making VCA transplants especially difficult to match across short distances, thereby significantly limiting the number of transplants.

At the same time, thanks to rapid advances in immunosuppression drugs as well as surgical techniques, the demand is nonetheless increasing rapidly. As such, enabling extended preservation/banking of VCAs is needed to provide the time for proper matching, which would make the procedure much more clinically available, thus greatly benefiting patients with burn injury, most notably patients at Shriners Hospitals for Children — Boston.