Evidence map›Paper›PMID 41847879›Full record

SynthesisCell transplantation

Vascularized composite xenotransplantation: Where we have been and where we could go?

Tobias Niederegger, Thomas Schaschinger, Gabriel Hundeshagen, Samuel Knoedler, Jule C Brandt, Jan O Voss, Max Heiland, Curtis L Cetrulo, Alexandre G Lellouch, Leonard Knoedler

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cell transplantation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Tobias NiedereggerMedical Faculty, University of Heidelberg, Heidelberg, Germany.
Thomas SchaschingerMedical Faculty, University of Heidelberg, Heidelberg, Germany.
Gabriel HundeshagenDepartment of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center. BG Trauma Center Ludwigshafen, University of Heidelberg, Heidelberg, Germany.
Samuel KnoedlerDivision of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jule C BrandtMedical Faculty, University of Heidelberg, Heidelberg, Germany.ORCID 0009-0001-4703-0835
Jan O VossDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Curtis L CetruloDepartment of Plastic, Reconstructive and Aesthetic Surgery, Cedars Sinai Hospital, Los Angeles, CA, USA.
Alexandre G LellouchDepartment of Plastic, Reconstructive and Aesthetic Surgery, Cedars Sinai Hospital, Los Angeles, CA, USA.
Leonard KnoedlerDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Vascularized composite allotransplantation (VCA) enables functional and aesthetic reconstruction after complex tissue loss but remains limited by donor scarcity and immunosuppression. Xenotransplantation, using tissues from other species, offers a potential solution. While progress in solid organ xenografts has accelerated, vascularized composite xenotransplantation (VCX) remains largely experimental. This study presents the first systematic review of VCX, tracing its development over the past century and preclinical efforts to overcome immunologic and technical barriers. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines searched PubMed, EMBASE, Cochrane, Web of Science, and Google Scholar for English-language VCX studies. Methodological quality was assessed using the Newcastle-Ottawa Scale, SYRCLE Risk of Bias tool, and Oxford Levels of Evidence. Of 257 records, six preclinical studies (1885-2023) met inclusion criteria. Donor species included pigs, rabbits, dogs, and humans; recipients were rodents or nonhuman primates. Most used heterotopic grafts (e.g., limbs, groin flaps, thymosternal blocks) combining skin, muscle, bone, and nerves. Techniques included cryopreservation, microsurgical anastomosis, and genetically modified pig grafts (e.g., GalTKO.hCD46). All demonstrated short-term survival without long-term function. Despite technical feasibility, VCX remains experimental. Advances in gene editing, immune modulation, and tissue engineering are essential for clinical translation and may ultimately redefine reconstructive transplantation.

Indexed as

Transplantation, HeterologousVascularized Composite AllotransplantationAnimalsHumansgene editingimmunomodulationreconstructive transplantationvascularized composite xenotransplantationxenografts

Identifiers

PMID41847879
PMCPMC13009779

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.