Extending the boundaries of transplantation

Abstract

Is there a clinical need? The first of these questions is probably the easiest to answer. Most of the defects being considered for transplantation lead to high physical and psychological morbidity. For example, loss of the hand is a devastating event, particularly if it is bilateral. Most such patients are young, and many are unable to live independently. Despite advances in surgery, it is impossible to reconstruct the hand with autologous tissues. The only therapeutic alternative to reconstruction is a prosthesis. Prostheses have limited function and cannot reproduce either the intricate actions of a hand or its appearance. The only way of providing these patients with a replacement limb that looks normal and can function well is to use allogenic tissue. With other situations, such as loss of the larynx, the need for allogenic tissue is even clearer. The larynx, unlike the hand, cannot be replaced by a prosthesis; the only potential solution to its loss is transplantation. In these specific clinical scenarios, a potent argument can be made for the use of cadaveric tissue for reconstruction.