Composite tissue allotransplantation (CTA) is a nascent field within the realm of reconstructive surgery. When
autologous tissue is neither available nor sufficient to reconstruct complex defects of the human form, CTA may
provide an alternative. However, the use of CTA is limited by the potential side-effects of chronic
immunosuppression such as malignancies, opportunistic infections and organ toxicity.
One research objective in CTA is to reduce and optimize immunosuppressive therapy, while the overall goal is to
perform composite tissue allotransplantation without any long-term systemic immunosuppressive treatment.
In order to better understand the molecular mechanisms responsible for the strong immune response towards the
skin, the expression of genes in the skin in response to limb allotransplantation will be addressed. Microarray
technology shows the whole gene expression profile at a single time point. Hence, genes and pathways previously
not related to the process of acute rejection can be detected and related in time to the induction and progression of
skin rejection. Differential gene expression analysis might enable the early diagnosis of rejection, facilitate
adjustments in immunosuppresion, and help develop new immunosuppressive treatment protocols for composite
tissue allotransplantation.