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Publications

Journal Article Review Ppublish

PubMed: 40790802 DOI: 10.1177/09636897251347749

The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review.

Cell Transplant 34:9636897251347749

Authors: Leonard Knoedler, Daniel H Mendelsohn, Loïc Van Dieren, Thomas Schaschinger, Cosima C Hoch, Max Heiland, Jasper Iske, Felix J Klimitz, Maxime Jeljeli, Korkut Uygun, Curtis L Cetrulo, Alexandre G Lellouch

Affiliations

  • Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
  • Institute of Pathology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
  • Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Shriners Hospitals for Children, Boston, MA, USA.
  • Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
  • Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Department of Otolaryngology, Head and Neck Surgery, TUM School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
  • Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany.
  • Division of Plastic Surgery, Yale School of Medicine, Department of Surgery, New Haven, CT, USA.
  • Department of Plastic, Reconstructive and Aesthetic Surgery, Cedars Sinai Hospital, Los Angeles, USA.
  • INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Université Paris Cité (2- AP-HP), Paris, France.
  • Hematology department, Hôpital Européen Georges Pompidou, Université Paris Cité (2- AP-HP), Paris, France.

Abstract

Vascularized composite allotransplantation (VCA) has emerged as an innovative strategy to restore form and function in patients with severe tissue defects involving anatomical regions such as the face, hand, and abdominal wall. Composite allografts are composed of diverse tissues, including skin, muscle, bone, vasculature, nerves, and mucosal surfaces, posing unique challenges in immunological management. Clinical outcomes following VCA surgeries have been encouraging; however, a comprehensive understanding of the underlying cellular interactions and molecular pathways is still predominantly derived from studies in solid organ transplantation (SOT). Recent advances in SOT have identified mitochondria as crucial therapeutic targets capable of mediating transplant rejection, mitigating ischemia-reperfusion injury (IRI), and enhancing graft longevity. Nevertheless, the explicit role and potential therapeutic applications of mitochondria within VCA remain largely unexplored. This review aims to critically examine and elucidate the significance of mitochondria in overcoming the current limitations encountered in VCA surgery. A deeper insight into mitochondrial biology could hypothetically provide clinicians and researchers with novel, targeted therapeutic strategies to improve clinical outcomes in VCA; however, these approaches require further validation in preclinical models.

MeSH

Vascularized Composite Allotransplantation, Pharmaceutical Preparations, Mitochondria, Reperfusion Injury, Transplants, Therapeutics, Cell Transplantation, Plastic Surgery Procedures, Tissues, Transplantation