Skin Immunology and Rejection in VCA and Organ Transplantation

D. A. Leonard, K. R. Amin, H. Giele, J. E. Fildes, Jason K. F. Wong

Research output: Contribution to journalArticlepeer-review


Purpose of Review
Skin provides a window into the health of an individual. Using transplanted skin as a monitor can provide a powerful tool for surveillance of rejection in a transplant. The purpose of this review is to provide relevant background to the role of skin in vascularized transplantation medicine.

Recent Findings
Discrete populations of T memory cells provide distributed immune protection in skin, and cycle between skin, lymph nodes, and blood. Skin-resident TREG cells proliferate in response to inflammation and contribute to long-term VCA survival in small animal models. Early clinical studies show sentinel flap rejection to correlate well with facial VCA skin rejection, and abdominal wall rejection demonstrates concordance with visceral rejection, but further studies are required.

This review focuses on the immunology of skin, skin rejection in vascularized composite allografts, and the recent advances in monitoring the health of transplanted tissues using distant “sentinel” flaps.
Original languageEnglish
Pages (from-to)251-259
JournalCurrent Transplantation Reports
Issue number4
Early online date11 Nov 2020
Publication statusPublished - 1 Dec 2020


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