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Clinical and Developmental Immunology
Volume 2012, Article ID 107901, 7 pages
Review Article

Improving the Safety of Tolerance Induction: Chimerism and Cellular Co-Treatment Strategies Applied to Vascularized Composite Allografts

1Division of Plastic and Reconstructive Surgery, Tzu Chi General Hospital, New Taipei 231, Taiwan
2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
3Division of Plastic Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei 110, Taiwan
4Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
5Cancer Immunotherapy Program, Cancer Center, Taipei Medical University Hospital and Center of Excellence for Cancer Research, Taipei Medical University, 252 Wu-Hsing Street, Taipei 110, Taiwan

Received 19 June 2012; Accepted 17 August 2012

Academic Editor: Gerald Brandacher

Copyright © 2012 Wei-Chao Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Although vascularized composite allografts (VCAs) have been performed clinically for a variety of indications, potential complications from long-term immunosuppression and graft-versus-host disease remain important barriers to widespread applications. Recently it has been demonstrated that VCAs incorporating a vascularized long bone in a rat model provide concurrent vascularized bone marrow transplantation that, itself, functions to establish hematopoietic chimerism and donor-specific tolerance following non-myeloablative conditioning of recipients. Advances such as this, which aim to improve the safety profile of tolerance induction, will help usher in an era of wider clinical VCA application for nonlife-saving reconstructions.