ArticleAnnals of surgery2013
Upper-extremity transplantation using a cell-based protocol to minimize immunosuppression.
Article in Annals of surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 66 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Pittsburgh Protocol in Human Upper Extremity Allotransplantation
Human Upper Extremity Allotransplantation
Human Craniomaxillofacial Allotransplantation
Human Penile Allotransplantation
Who cites it
66 citing papers in PubMed, 1 synthesis or guideline pooled it, 210 citations in OpenAlex.
- Challenges and opportunities in vascularized composite allotransplantation of joints: a systematic literature review.Frontiers in immunology · 2023Pooled it
- Where Do We Stand for Nerve Regeneration and Functional Recovery After Vascularized Composite Allotransplantation?Microsurgery · 2026Review
- Donor adipose-derived stromal cells are vasoprotectant but unable to revert acute rejection in rodent vascularized composite allotransplants.Frontiers in immunology · 2025Article
- Review
- Advancing vascularized composite allotransplantation: essential factors for upper extremity transplant program development.Frontiers in transplantation · 2024Article
- Immune modulation in transplant medicine: a comprehensive review of cell therapy applications and future directions.Frontiers in immunology · 2024Review
- Immunosuppressive strategies in face and hand transplantation: a comprehensive systematic review of current therapy regimens and outcomes.Frontiers in transplantation · 2024Review
- Immunogenicity and tolerance induction in vascularized composite allotransplantation.Frontiers in transplantation · 2024Review
- Human Multi-Chimeric Cell (HMCC) Therapy as a Novel Approach for Tolerance Induction in Transplantation.Stem cell reviews and reports · 2023Article
- High prevalence of pre-eclampsia in women with coarctation of the aorta.European heart journal open · 2023Article
- Lessons learned from the first 15 years of penile transplantation and updates to the Baltimore Criteria.Nature reviews. Urology · 2023Review
- Characterization and Function of Cryopreserved Bone Marrow from Deceased Organ Donors: A Potential Viable Alternative Graft Source.Transplantation and cellular therapy · 2023Article
- The research landscape on vascularized composite allografts: a bibliometric analysis (2002-2021).American journal of translational research · 2023Article
- Development of a rat forelimb vascularized composite allograft (VCA) perfusion protocol.PloS one · 2023Article
- Novel Human Umbilical Di-Chimeric (HUDC) cell therapy for transplantation without life-long immunosuppression.Stem cell investigation · 2023Article
- Patient definitions of transplant success in upper extremity vascularized composite allotransplantation: A mixed-methods study.SAGE open medicine · 2023Article
- Tolerance Induction in Vascularized Composite Allotransplantation-A Brief Review of Preclinical Models.Transplant international : official journal of the European Society for Organ Transplantation · 2023Review
- Cell therapy in vascularized composite allotransplantation.Biomedical journal · 2022Review
- Creation of human hematopoietic chimeric cell (HHCC) line as a novel strategy for tolerance induction in transplantation.Stem cell investigation · 2022Article
- The intragraft vascularized bone marrow induces secondary donor-specific mystacial pad allograft tolerance.Frontiers in immunology · 2022Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveTo minimize maintenance immunosuppression in upper-extremity transplantation to favor the risk-benefit balance of this procedure.
backgroundDespite favorable outcomes, broad clinical application of reconstructive transplantation is limited by the risks and side effects of multidrug immunosuppression. We present our experience with upper-extremity transplantation under a novel, donor bone marrow (BM) cell-based treatment protocol ("Pittsburgh protocol").
methodsBetween March 2009 and September 2010, 5 patients received a bilateral hand (n = 2), a bilateral hand/forearm (n = 1), or a unilateral (n = 2) hand transplant. Patients were treated with alemtuzumab and methylprednisolone for induction, followed by tacrolimus monotherapy. On day 14, patients received an infusion of donor BM cells isolated from 9 vertebral bodies. Comprehensive follow-up included functional evaluation, imaging, and immunomonitoring.
resultsAll patients are maintained on tacrolimus monotherapy with trough levels ranging between 4 and 12 ng/mL. Skin rejections were infrequent and reversible. Patients demonstrated sustained improvements in motor function and sensory return correlating with time after transplantation and level of amputation. Side effects included transient increase in serum creatinine, hyperglycemia managed with oral hypoglycemics, minor wound infection, and hyperuricemia but no infections. Immunomonitoring revealed transient moderate levels of donor-specific antibodies, adequate immunocompetence, and no peripheral blood chimerism. Imaging demonstrated patent vessels with only mild luminal narrowing/occlusion in 1 case. Protocol skin biopsies showed absent or minimal perivascular cellular infiltrates.
conclusionsOur data suggest that this BM cell-based treatment protocol is safe, is well tolerated, and allows upper-extremity transplantation using low-dose tacrolimus monotherapy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.