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

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

doi:10.1186/s12967-023-04379-x

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

J Transl Med. 2023 Sep 8;21(1):609. doi: 10.1186/s12967-023-04379-x.

Authors

Carolyn Ton^{1

2}, Sara Salehi^{1

2}, Sara Abasi^{3

4

5}, John R Aggas^{3

4

6}, Renee Liu^{1

2}, Gerald Brandacher⁷, Anthony Guiseppi-Elie^{8

9

10

11}, Warren L Grayson^{12

13

14

15

16}

Affiliations

¹ Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA.
² Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA.
³ Department 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.
⁴ Department 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.
⁵ Media and Metabolism, Wildtype, Inc., 2325 3rd St., San Francisco, CA, 94107, USA.
⁶ Test Development, Roche Diagnostics, 9115 Hague Road, Indianapolis, IN, 46256, USA.
⁷ Department 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. brandacher@jhmi.edu.
⁸ Department 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. guiseppi@tamu.edu.
⁹ Department 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. guiseppi@tamu.edu.
¹⁰ Department of Cardiovascular Sciences, Houston Methodist Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Ave., Houston, TX, USA. guiseppi@tamu.edu.
¹¹ ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA, USA. guiseppi@tamu.edu.
¹² Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA. wgrayson@jhmi.edu.
¹³ Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA. wgrayson@jhmi.edu.
¹⁴ Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA. wgrayson@jhmi.edu.
¹⁵ Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA. wgrayson@jhmi.edu.
¹⁶ Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA. wgrayson@jhmi.edu.

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.

Keywords: Bioanalytical methods; Biomarkers; Transplantation; VCA; Vascularized composite tissue allografts.

Publication types

Review
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Algorithms
Composite Tissue Allografts*
Quality of Life
Transplantation, Homologous
Vascularized Composite Allotransplantation*