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Allotransplantation (allo- from the Greek meaning "other") is the transplantation of cells, tissues, or organs, to a recipient from a genetically non-identical donor of the same species.^[1] The transplant is called an allograft, allogeneic transplant, or homograft. Most human tissue and organ transplants are allografts. A xenograft is a graft from a different species, such as when animal tissue is grafted to help humans.

It is not uncommon for patients and physicians to use the term "allograft" imprecisely to refer to either allograft (human-to-human) or xenograft (animal-to-human), but it is helpful scientifically (for those searching or reading the scientific literature) to maintain the more precise distinction in usage.

An immune response against an allograft or xenograft is termed rejection. An allogenic bone marrow transplant can result in an immune attack termed Graft-versus-host disease.

Procedure[edit]

Informed consent is required before tissue is harvested from a donor, alive or dead. Proper screening for pathology and risk factors for communicable diseases such as HIV and Hepatitis B and C is then conducted.

In the US, donor tissue must be harvested and processed adhering to the Current Good Tissue Practices rule. In most cases it is sent to tissue banks for processing and distribution. Each year, Food and Drug Administration regulated and American Association of Tissue Banks-accredited tissue banks distribute 1.5 million bone and tissue allografts.

Transplantable organs and tissues[edit]

Main article: Transplantable organs and tissues

A variety of organs and tissues can be used for allografts, including:

Anterior cruciate ligament (ACL) repair
Joint reconstruction in the knee and ankle
Meniscal replacement
Reconstruction due to cancer or trauma
Ridge augmentation in dental procedures
Shoulder repair
Spinal fusion
Urological procedures
skin transplants
corneal transplants
heart transplants
heart valves
lung transplantation
Intestinal transplantation (Isolated Small Bowel, Intestine & Liver, Multivisceral)
liver transplants
kidney transplants
bone marrow transplants
bone allograft
ligament or tendon allograft

Laws & regulations[edit]

In the US, the Federal government Food and Drug Administration (FDA) has regulated human tissue intended for transplants since 1993. In order to ensure the quality of donor tissue and reduce contamination and disease transmission risks three regulations addressing manufacturing activities associated with human cells, tissues, and cellular and tissue-based products (HCT/Ps) were promulgated in May 2005: The first requires companies producing and distributing HCT/Ps to register with the FDA. The second, called the “Donor Eligibility” rule, proscribes criteria for donor eligibility. The third, the “Current Good Tissue Practices” rule, oversees overall processing and distribution practices of each company.

Other transplant options[edit]

Autograft, tissue transplanted from one site to another on the same patient. An autograft reduces the risk of rejection but requires a second surgery site, adding pain, risk and possible longer aftercare.

Xenograft, a transplant from another species

Isograft, a transplant from a genetically identical donor, such as an identical twin.

Synthetic and metal implants. Unlike allografts, such grafts do not corporate into the body.

External links[edit]

http://www.aatb.org/files/safetyoftissuetransplants.pdf
http://www.cdc.gov/ncidod/dhqp/tissueTransplantsFAQ.html#top
http://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/default.htm
http://www.organdonor.gov/donor/registry.shtm (How to register to be a donor in the USA)
Allogeneic stem cell transplantation entry in the public domain NCI Dictionary of Cancer Terms
Allogeneic bone marrow transplantation entry in the public domain NCI Dictionary of Cancer Terms

References[edit]

^ Surgery For ACL Tears

UpToDate Contents

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1. 異種移植および腎臓 xenotransplantation and the kidney
2. 薬物アレルギー：病因 drug allergy pathogenesis

English Journal

The renal microenvironment modifies dendritic cell phenotype.

Chessa F1, Mathow D1, Wang S1, Hielscher T2, Atzberger A3, Porubsky S1,4, Gretz N5, Burgdorf S6, Gröne HJ1, Popovic ZV1,4.
Kidney international.Kidney Int.2015 Oct 14. doi: 10.1038/ki.2015.292. [Epub ahead of print]
Renal dendritic cells are a major component of the renal mononuclear phagocytic system. In the renal interstitium, these cells are exposed to an osmotic gradient, mainly sodium, whose concentration progressively increases towards inner medulla. Renal allograft rejection affects predominantly the cor
PMID 26466317

The bone marrow microenvironment is similarly impaired in allogeneic hematopoietic stem cell transplantation patients with early and late poor graft function.

Kong Y1, Wang YT1, Hu Y1,2, Han W1, Chang YJ1, Zhang XH1, Jiang ZF2,3, Huang XJ1,2.
Bone marrow transplantation.Bone Marrow Transplant.2015 Oct 5. doi: 10.1038/bmt.2015.229. [Epub ahead of print]
Poor graft function (PGF), including early and late PGF, is a serious complication following allotransplant. We recently reported that bone marrow microenvironment abnormalities may occur in cases of late PGF. Whether these abnormalities occur in early PGF remains unknown. To answer this question, w
PMID 26437066

NUTRITION IN ALLOGENEIC STEM CELL TRANSPLANTION - CLINICAL GUIDELINES AND IMMUNOBIOLOGICAL ASPECTS.

Tvedt TH, Reikvam H, Bruserud Ø1.
Current pharmaceutical biotechnology.Curr Pharm Biotechnol.2015 Sep 30. [Epub ahead of print]
Even though malnutrition is associated with an adverse prognosis after allogeneic stem cell transplantation, few studies have addressed the question what is the optimal nutritional support for these patients. There is a general agreement that the body weight, body mass index and nutritional intake c
PMID 26420050