SEARCHNARRATIVE_REVIEWsurgery, immunology

narrative_review·surgery, immunology, biomedical research, research methods·PMC10492401

Methods of ex vivo analysis of tissue status in vascularized composite allografts

Journal of Translational Medicine · 8 authors, 12 centres

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TL;DR

This narrative review surveys bioanalytical methods for evaluating the status of vascularized composite allografts (VCAs) ex vivo, including implantable biochips, bioimpedance monitoring, and deep learning-based data fusion.

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This narrative review consolidates current bioanalytical methods for ex vivo assessment of vascularized composite allograft (VCA) tissue status. The authors describe how the complex multi-tissue composition of VCAs (skin, bone, muscle, nerve, fat, connective tissue) increases immunogenic rejection risk and how prolonged static cold storage can cause irreversible damage to susceptible tissues such as muscle and nerve. The authors conclude that while many tools show promise in experimental settings, quantitative evidence linking ex vivo monitoring metrics to actual transplant outcomes is currently insufficient, and further analytical development is needed to bridge this gap.

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narrative_review

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surgery

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ORIGINAL PAPER

PMC10492401

Methods of ex vivo analysis of tissue status in vascularized composite allografts

Journal of Translational Medicine

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ABSTRACT

Vascularized composite allotransplantation can improve quality of life and restore functionality. However, the complex tissue composition of vascularized composite allografts (VCAs) presents unique clinical challenges that increase the likelihood of transplant rejection. Under prolonged static cold storage, highly damage-susceptible tissues such as muscle and nerve undergo irreversible degradation that may render allografts non-functional. Skin-containing VCA elicits an immunogenic response that increases the risk of recipient allograft rejection. The development of quantitative metrics to evaluate VCAs prior to and following transplantation are key to mitigating allograft rejection. Correspondingly, a broad range of bioanalytical methods have emerged to assess the progression of VCA rejection and characterize transplantation outcomes. To consolidate the current range of relevant technologies and expand on potential for development, methods to evaluate ex vivo VCA status are herein reviewed and comparatively assessed. The use of implantable physiological status monitoring biochips, non-invasive bioimpedance monitoring to assess edema, and deep learning algorithms to fuse disparate inputs to stratify VCAs are identified.

CITATION EXPORT

Carolyn Ton, Sara Salehi, Sara Abasi et al.. Methods of ex vivo analysis of tissue status in vascularized composite allografts. Journal of Translational Medicine. (2023). https://doi.org/10.1186/s12967-023-04379-x

AUTHORS

8 · 12 CENTRES

Carolyn Ton, Sara Salehi, Sara Abasi, John R. Aggas, Renee Liu, Gerald Brandacher, Anthony Guiseppi-Elie, Warren L. Grayson

1https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD 21231 USA
2https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD 21231 USA
3https://ror.org/01f5ytq51grid.264756.40000 0004 4687 2082Department of Biomedical Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX 77843 USA
4https://ror.org/01f5ytq51grid.264756.40000 0004 4687 2082Department of Electrical and Computer Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX 77843 USA
5Media and Metabolism, Wildtype, Inc., 2325 3rd St., San Francisco, CA 94107 USA
6grid.418158.10000 0004 0534 4718Test Development, Roche Diagnostics, 9115 Hague Road, Indianapolis, IN 46256 USA
7https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Reconstructive Transplantation Program, Center for Advanced Physiologic Modeling (CAPM), Johns Hopkins University, Ross Research Building/Suite 749D, 720 Rutland Avenue, Baltimore, MD 21205 USA
8https://ror.org/027zt9171grid.63368.380000 0004 0445 0041Department of Cardiovascular Sciences, Houston Methodist Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Ave., Houston, TX USA
9ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA USA
10https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD USA
11https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD USA
12https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD USA