Vascular Composite Tissue Allotransplantaion and Immunomodulation

Improved body armor and personal protective equipment, used in the Iraq and Afghanistan conflicts, have reduced injuries to body areas most likely to prove immediately lethal, especially the chest and abdomen. Such protection, especially when combined with improvements in trauma care, resulted in greatly improved survival of Wounded Warriors, compared with previous wars. But some of the wounds, especially in unprotected regions such as the face and extremities, were of unprecedented severity, which challenged conventional reconstructive surgery beyond it abilities to restore form and function. Amputation of one or both upper extremities is a paradigm shift for a young Warfighter, for some of whom prosthetic use is unsatisfactory. The loss of recognizable or functional facial regions is wholly life-changing, and an injury for which there is no prosthesis. These Wounded Warriors need a different solution.

Face and hand transplantation offer some catastrophically wounded individuals the potential for a more integrated, independent, functional life.

In addition to funding human transplant procedures the team supports all stages of research, from laboratory science to clinical investigations, covering topics like:

• Immune tolerance to reduce the risk of transplant rejection
• New techniques to lengthen the time surgeons have to transplant the tissue
• Processes to make monitoring of such transplants uniform across the institutions that perform the surgeries
• Advancing the science and clinical procedures toward a "standard of care" for future hand and face transplant recipients