Immunomodulation in vascularized composite allotransplantation: What is the role for adipose-derived stem cells?

Sara Di Lorenzo, Francesco Dieli, Luigi Montesano, Francesca Toia, Francesco Moschella, Anna Barbara Di Stefano, Serena Meraviglia, Antonio Russo, Marco Pappalardo, Angelo A. Leto Barone, Antonio Russo, Francesco Dieli, Anna Barbara Di Stefano, Serena Meraviglia, Angelo Alberto Leto Barone

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Hand and face transplants are becoming increasingly common, recording progressively more penile, uterus, abdominal wall, and allotransplantation cases reported worldwide. Despite current protocols allow long-term survival of the allografts, the ultimate goal of donor-specific tolerance has not been achieved yet. In fact, the harmful adverse effects related to the lifelong administration of immunosuppressive agents are the main drawbacks for vascularized composite allotransplantations. Research is very active in investigating alternative methods to induce greater tolerance while minimizing toxicity. Adipose-derived stem cells (ASCs) represent promising cell therapies for immunomodulation in preclinical and clinical settings. Their clinical appeal is due to their easy harvest in large quantities through a noninvasive and well-accepted approach; they may well promote donor-specific tolerance and potentially reduce immunosuppression. Several experimental studies exist, but lacking review articles reporting current evidence. This work proposes a literature review on the immunomodulatory role of ASCs in vascularized composite allotransplantations. In vitro and in vivo evidence will be summarized. The role that cell passaging and upstream progenitors - the so-called spheroid ASCs - may play in modulating the immune response will also be discussed. Finally, this article will summarize current knowledge on biodistribution, migration, and homing of injected stem cells. This review may well provide useful information for preclinical and clinical studies, aiming at a breakthrough for donor-specific tolerance.
Original languageEnglish
Pages (from-to)245-251
Number of pages7
JournalAnnals of Plastic Surgery
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Surgery


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