Evidence map›Paper›PMID 41665096›Full record

ReviewMicrosurgery2026

Where Do We Stand for Nerve Regeneration and Functional Recovery After Vascularized Composite Allotransplantation?

Olivier Mathieu, Leonard Knoedler, Thomas Schaschinger, Jakob Fenske, Felix J Klimitz, Maxime Jeljeli, Curtis L Cetrulo, Alexandre G Lellouch

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Microsurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Olivier MathieuDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Leonard KnoedlerDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Thomas SchaschingerCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353, Berlin, Germany.ORCID https://orcid.org/0009-0000-6523-1641
Jakob FenskeCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353, Berlin, Germany.ORCID https://orcid.org/0009-0000-3453-3903
Felix J KlimitzDivision of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0002-1278-0505
Maxime JeljeliDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Curtis L CetruloDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Alexandre G LellouchDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionVascularized composite allotransplantation (VCA) offers a reconstructive solution for patients with severe limb and facial defects by transplanting multiple tissue types-including skin, muscle, bone, and nerves-as a single unit. This review examines current challenges in nerve regeneration and functional recovery following VCA, and assesses emerging strategies aimed at overcoming these hurdles.

methodsA comprehensive literature review was conducted, focusing on clinical outcomes from upper limb and facial transplantation programs worldwide. Studies evaluating rehabilitation protocols, transplantation levels, follow-up durations, and experimental strategies (cellular therapies, biomaterials, and neurotrophic factor delivery) were analyzed to determine their impact on nerve regeneration and functional recovery.

resultsClinical evidence indicates that while protective sensation can return within months after VCA, motor function recovery often extends over several years. Variability in outcomes has been noted, largely due to differences in rehabilitation practices, assessment metrics, and follow-up duration. Experimental approaches, including stem cell-based therapies-especially those using adipose-derived stem cells-demonstrate potential for enhancing axonal regeneration and modulating immune responses, although the long-term benefits and standardized measures remain to be fully established.

conclusionsDespite promising advancements in surgical techniques and immunosuppressive regimens, effective nerve regeneration in VCA remains a significant challenge. The variability in clinical outcomes underscores the need for standardized functional assessment protocols and further research into novel regenerative therapies. Future studies should focus on refining these therapeutic strategies to improve long-term functional recovery and minimize the reliance on chronic immunosuppression.

Indexed as

Nerve RegenerationRecovery of FunctionVascularized Composite AllotransplantationHumansTreatment Outcomeface transplantationfunctional recoverynerve regenerationvascularized composite allotransplantationVCA

Identifiers

PMID41665096
PMCPMC12888073

What OpenQuestion holds

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Registered trials

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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.