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The landscape of vascularized composite allograft donation in the United States

Henderson, Macey L.a,b

Current Opinion in Organ Transplantation: December 2019 - Volume 24 - Issue 6 - p 699–704
doi: 10.1097/MOT.0000000000000703

Purpose of review Vascularized composite allograft (VCA) donation and transplantation has now demonstrated feasibility and impact to the lives of patients suffering from devastating and traumatic injury. This review summarizes the current landscape of VCA donation in the United States.

Recent findings VCA donations are nonlife-saving allografts, for nonlife-saving transplants – and therefore, conservative donor selection focused on the optimization of donors for the lowest risk to transplant recipients is paramount. VCA donors in the United States are a demographically and clinically diverse group that largely reflects the characteristics of the VCA candidates waiting for transplants. Public opinion about VCA donation is generally supportive, but has lower support for VCA transplants than for solid organ transplants.

Summary As an emerging area of transplantation, VCA donation is evolving in the United States with growing interest by the public, and those suffering from catastrophic injury for which reconstructive transplantation may offer excellent outcomes and a high quality of life.

aDepartment of Surgery, Division of Transplantation, Johns Hopkins School of Medicine

bDepartment of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA

Correspondence to Macey L. Henderson, JD, PhD, Assistant Professor of Surgery, Johns Hopkins School of Medicine, Director of Policy and External Affairs, The Epidemiology Research Group in Organ Transplantation, 2000 E Monument Street, Baltimore, MD 21205, USA. Tel: +1 443 287 6649; fax: +1 410 630 7217; e-mail:

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