Best practices of hind limb transplantation in mice

Vascularized composite allotransplantation has emerged as a valuable reconstructive option that enables the transfer of multiple tissue types, including skin, muscle, bone, nerves, and blood vessels, as a functional unit for patients with extensive tissue loss. Murine models, particularly the hind limb transplantation models, have become indispensable tools for advancing our understanding of the complex immunologic and physiological aspects of vascularized composite allotransplantation. This review provides a comprehensive description of established protocols for orthotopic and heterotopic hind limb transplantation in mice. It also discusses critical technical considerations and evaluates the models' utility, impact, and limitations. By examining various aspects, including surgical techniques, immunosuppression regimens, rejection criteria, and translational relevance, this review aims to highlight best practices for the harmonization of the use of this valuable preclinical model in supporting continuous progress in the field.