Preclinical Models in Vascularized Composite Allotransplantation

Vascularized composite allotransplantation (VCA) has the potential to reconstruct any non-visceral tissue defect, using like for like tissue, delivering optimal form and function. Over 150 VCA transplants have been performed worldwide; however, this treatment remains experimental. Things systematically tried in the clinic should follow thorough science and tested in a model that allows predicting as possible the safety of the procedure. This is generally the function of animal experimentation. Advantages of preclinical models include greater control of bias, of subject numbers and of variables compared to clinical trials. Limitations include differences between species in anatomy and physiology as well as ethical, logistical and technical constraints. Multiple models have been described; however, no single model is ideal in all areas. This paper reviews historical perspectives, current models and future direction in VCA research.