PLASTIC SURGERY
Fig. 3. Diligent efforts of the recipient achieved
excellent function.
liver and multi-visceral organ transplants, when the abdominal
cavity is too small to accommodate the transplanted organs. This is
life-saving in these cases, and recipients would need immunosup-
pression anyway for their visceral organs. Over 30 such transplants
have now been done.
PENIS TRANSPLANTS
With techniques perfected in South Africa, penis transplants are
now being done at Massachusetts General Hospital and Johns
Hopkins Hospital for injuries coming from the wars in Iraq and
Afghanistan due to improvised explosive devices. These programs
are funded by the Department of Defense and are highly advocated
by injured veterans. A few children have now been fathered by penis
transplant recipients.
UTERINE TRANSPLANTS
Uterine transplants carry mucosa and endometrium, rather than
skin. At this time, this field is the most rapidly growing in VCA. To
date, there have been 50 uterine transplants, with over 10 healthy
children delivered, all by caesarean section. The most active pro-
gram is in Sweden, with several programs recently established in
the United States. To avoid the risks of long-term immunosup-
pression, recipients are limited to two children, and the uterus is
then explanted.
include transplants of the larynx/trachea, tongue, peripheral nerve,
knee/femur, and leg/foot.
THE ENDURING LOUISVILLE CONTRIBUTIONS
Breakthroughs in immune science to eliminate the need for lifelong
immunosuppression will likely be the key to the future of VCA. In
whatever manner the field evolves, the enduring contributions of the
Louisville program will be more than pioneering and performing
the first long-term success of a skin-bearing transplant. The endur-
ing contributions will include the intense ethical focus guiding the
effort, and the careful patient selection process used.
Dr. Gordon Tobin is a professor at the University of Louisville School of
Medicine, Department of Surgery, Division of Plastic and Reconstructive
Surgery. He practices with UofL Physicians-Plastic and Reconstructive
Surgery.
Dr. Christopher Jones is a practicing transplant surgeon specialist with
UofL Physicians.
Dr. Christina L. Kaufman is the Executive Director of the Christine M.
Kleinert Institute for Hand and Microsurgery (CMKI). She is an Assistant
Professor in the Division of Hand Surgery at the University of Louisville.
OTHER VCA
A number of other VCA’s have been done in small numbers. These
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