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

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, mu...

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Main 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
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Cell Transplantation
Online Access:https://doi.org/10.1177/09636897251347749
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author 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
author_facet 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
author_sort Leonard Knoedler
collection DOAJ
description 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.
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spelling doaj-art-908b0ef413de40f5a55e852a82a90f902025-08-20T03:41:31ZengSAGE PublishingCell Transplantation1555-38922025-08-013410.1177/09636897251347749The future role of mitochondrial drugs in vascularized composite allotransplantation: A short reviewLeonard Knoedler0Daniel H. Mendelsohn1Loïc Van Dieren2Thomas Schaschinger3Cosima C. Hoch4Max Heiland5Jasper Iske6Felix J. Klimitz7Maxime Jeljeli8Korkut Uygun9Curtis L. Cetrulo10Alexandre G. Lellouch11Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyInstitute of Pathology, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyVascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USADepartment of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Otolaryngology, Head and Neck Surgery, TUM School of Medicine and Health, Technical University of Munich (TUM), Munich, GermanyDepartment of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, GermanyDivision of Plastic Surgery, Yale School of Medicine, Department of Surgery, New Haven, CT, USADepartment of Plastic, Reconstructive and Aesthetic Surgery, Cedars Sinai Hospital, Los Angeles, USAShriners Hospitals for Children, Boston, MA, USADepartment of Plastic, Reconstructive and Aesthetic Surgery, Cedars Sinai Hospital, Los Angeles, USAHematology department, Hôpital Européen Georges Pompidou, Université Paris Cité (2- AP-HP), Paris, FranceVascularized 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.https://doi.org/10.1177/09636897251347749
spellingShingle 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
The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review
Cell Transplantation
title The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review
title_full The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review
title_fullStr The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review
title_full_unstemmed The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review
title_short The future role of mitochondrial drugs in vascularized composite allotransplantation: A short review
title_sort future role of mitochondrial drugs in vascularized composite allotransplantation a short review
url https://doi.org/10.1177/09636897251347749
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