The immunology of composite tissue transplantation

Composite tissue allotransplantation holds great potential for reconstructive surgery. That these procedures can be successful has been clearly demonstrated by the success of hand, face, and larynx transplants around the world. Although the immunology of composite tissue allotransplantation mirrors that of any allogeneic organ transplant, there are several unique aspects to these grafts. This article reviews the immunology of transplantation, histocompatibility testing for composite tissue allotransplantation, graft rejection, immunosuppression, and specific immunologic considerations of composite tissue allotransplantation.