Vascular composite allografts (VCA) are highly antigenic as demonstrated by near universal rejection rates. Nonetheless, substantial immunosuppressive therapy has permitted VCA to survive currently between 10 (face) and 15 (hand) years. The field of VCA has placed major emphasis on investigating in preclinical and clinical trials whether infused bone marrow combined with standard immunosuppression may improve immunologic outcomes. In contrast to solid organ transplant protocols utilizing bone marrow cells (BMC) and nonmyeloblative conditioning, tolerance (or even the absence of rejection on immunosuppression) has not been observed in any VCA trials (1–3).
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Brazio et al. (2015) studied this question.
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