Cellular Activation Pathways and Interaction Networks in Vascularized Composite Allotransplantation

Vascularized composite allotransplantation (VCA) is a transformative approach in reconstructive surgery for severe injuries, involving the transplantation of multiple tissue types. A significant challenge in VCA is the strong rejection response, particularly due to the antigenicity of components like skin, necessitating lifelong immunosuppression. This review explores the cellular mechanisms involved in graft rejection, highlighting the roles of various immune cells and donor-derived tissues. Recent advancements in understanding these cellular interactions may lead to new therapies targeting specific processes, potentially improving the clinical management of VCA patients.