IN A MAJOR STEP INTO A NEW TRANSPLANTATION FRONTIER, UCLA has established a first-of-itskind program to restore functionality and enhance quality of life for people who have suffered severe trauma or other disfiguring injuries to the upper extremities, face or abdomen.
The UCLA Section of Reconstructive Transplantation represents a multidisciplinary effort to use a new transplantation approach known as vascularized composite allotransplantation to treat patients whose tissue loss cannot be remedied through conventional techniques.
While lifesaving solid-organ transplants have become increasingly common at major centers such as UCLA, reconstructive transplantation – a complex surgery involving composite tissues (bones, tendons, arteries, nerves) – marks a new direction for the field.
“Reconstructive transplantation is where we were with solid-organ transplantation in the mid-1980s,” says liver-transplant surgeon Ronald W. Busuttil, M.D., executive chair of the Department of Surgery. “With the experience that has been accrued in several centers throughout the world with reconstructive transplantation, it is clear that for certain patients, the outcomes can be life-changing and that major transplant centers such as UCLA should be pursuing this approach.”
The reconstructive transplants will focus on hands, the face and abdominal wall. The section will be led by Kodi Azari, M.D., a pioneer in the field who earlier this year at UCLA performed the first hand transplant in the Western United States.
One of the key tenets of plastic surgery is to use similar tissues from other parts of the patient’s body in reconstruction. But for parts of the body such as hands and the nose and mouth areas, there are no similar tissues. Through advanced microsurgical techniques, Dr. Azari and his colleagues will use composite tissues to construct what the body doesn’t readily provide.
In addition to the clinical program, a robust research effort is being initiated under the direction of Jerzy Kupiec-Weglinski, M.D., Ph.D., professor of surgery, pathology and laboratory medicine and director of the Dumont-UCLA Transplant Research Laboratories. The research will focus on ways to bolster the ability of the immune system to tolerate the composite-tissue transfer in an effort to reduce the need for immunosuppressive medications.