OPTN/SRTR 2024 Annual Data Report: Vascularized Composite Allograft

Area of Science:

• Transplantation immunology
• Regenerative medicine
• Surgical innovation

Background:

• Vascularized composite allografts (VCAs) were included in solid organ transplantation definitions in 2014.
• VCA procedure volumes in the U.S. have remained consistently low since 2014.
• Data collection spans approximately a decade, from 2014 to 2024.

Purpose of the Study:

• To summarize VCA transplant data from 2014-2024.
• To identify trends in VCA procedures, recipient/donor demographics, and indications.
• To report on graft survival rates and ongoing advancements in VCA standardization.

Main Methods:

• Comprehensive data summary of VCA procedures performed in the United States from 2014-2024.
• Analysis of recipient demographics (age, race, sex) and donor characteristics.
• Review of indications for transplantation and graft failure rates.

Main Results:

• 55 uterus transplants and 37 nonuterus transplants were reported between 2014-2024.
• Upper limb transplants were most common overall, but head and neck transplants were most frequent in 2024.
• Trauma was the leading indication for nonuterus VCAs; congenital indications for uterus transplants. Graft failure rates were low.

Conclusions:

• Despite low volumes, consistent trends in VCA procedures, demographics, and indications were observed.
• Low graft failure rates suggest progress, but limited data preclude definitive conclusions.
• Standardization of outcome measures and procedures is crucial for advancing VCA research and patient care.