Purpose of review: Vascularized composite allotransplantation (VCA) is a treatment for complex tissue injuries and defects of extremities and face. During the past thirteen years, more than 100 VCA cases have been reported. Form and function restored with VCA have exceeded the results achieved with conventional surgical techniques. The review summarized the development in VCA over the past 12 months with references of and comparison with solid organ transplantation.
Recent findings: The highlights reported in the latest publications included a better understanding of topical immunosuppressants for prevention and treatment of VCA rejection, mechanisms of chronic rejection and minimization of immunosuppressive maintenance treatment using a cell-based protocol in human upper-extremity transplantation.
Summary: We herein summarize the progress made in VCA in the last year with a focus on new clinical immunosuppressive strategies and novel targets for immunosuppression and immunomodulation including the application of mesenchymal stem cells for transplant tolerance.