Research Program

Our research seeks to address the major biological, technical, and clinical challenges of vascularized composite allotransplantation (VCA) and reconstructive transplantation. We combine experimental models, ex vivo perfusion, transplantation immunology, advanced tissue analysis, and clinical outcomes research to improve graft preservation, understand rejection, and promote durable functional recovery following face and extremity transplantation.

A major area of investigation is ex vivo perfusion and graft preservation. Using preclinical models of extremity transplantation and perfusion, we study ischemia-reperfusion injury, tissue viability, vascular and endothelial function, metabolism, and approaches to preserve the diverse tissues contained within a VCA graft, including skin, muscle, nerve, bone, and bone marrow. We are particularly interested in using ex vivo perfusion not only for preservation but also as a platform for graft assessment and targeted therapeutic intervention before transplantation.

Our transplant immunology and rejection research investigates the mechanisms underlying acute and chronic VCA rejection. Areas of interest include cellular and antibody-mediated immune responses, endothelial and microvascular injury, transplant vasculopathy, fibrosis, tissue-specific immune responses, and the development of biomarkers for earlier and more precise detection of graft injury.

Our clinical and translational research complements these experimental studies by examining long-term outcomes following face and upper-extremity transplantation, including graft survival, rejection, functional recovery, and approaches to immunosuppression.

Translational Research

VCA sits at the intersection of multiple scientific disciplines. Our laboratory therefore emphasizes collaboration across transplantation, immunology, pathology, bioengineering, and reconstructive surgery. By integrating mechanistic laboratory studies, preclinical transplantation models, advanced tissue analysis, and clinical observations, we seek to identify discoveries that can be translated into meaningful improvements in reconstructive transplantation.

Ex Vivo Perfusion & Graft Preservation

Vascularized composite allografts contain multiple tissues—including skin, muscle, nerve, bone, vasculature, and bone marrow—with distinct metabolic and preservation requirements. We develop and study ex vivo perfusion strategies designed to maintain these complex grafts outside the body, reduce ischemia-reperfusion injury, and improve tissue viability before transplantation.

Using preclinical extremity perfusion and transplantation models, we investigate perfusion conditions, oxygen delivery, metabolism, vascular integrity, and tissue-specific responses to preservation. We are also exploring ex vivo perfusion as a platform for graft assessment and targeted therapeutic intervention prior to transplantation.

Transplant Immunology & Rejection

Acute and chronic rejection remain major barriers to long-term success in VCA. Our laboratory investigates the cellular, molecular, and vascular mechanisms underlying allograft injury, with particular interest in the unique immunologic behavior of the different tissues contained within a composite graft.

Research areas include acute and chronic rejection, endothelial and microvascular injury, transplant vasculopathy, fibrosis, cellular and antibody-mediated immune responses, and tissue-specific mechanisms of graft injury. Our goal is to identify therapeutic targets that promote long-term graft survival while reducing the burden associated with systemic immunosuppression.

Biomarkers & Precision Monitoring

Earlier and more precise recognition of graft injury may allow intervention before irreversible structural damage develops. We investigate circulating, tissue-based, molecular, and histopathologic biomarkers of VCA rejection and graft health.

By integrating conventional histopathology with molecular and advanced spatial approaches, we aim to better characterize the immune microenvironment of transplanted tissues and identify signatures associated with graft injury, treatment response, and progression from acute to chronic rejection.

Experimental Models & Translational Therapeutics

Preclinical models provide an essential bridge between mechanistic discoveries and clinical transplantation. We use experimental perfusion and transplantation models to investigate graft physiology, ischemia-reperfusion injury, immune responses, tissue regeneration, and novel therapeutic strategies.

A particular focus is the development of interventions that can be delivered directly to the graft during ex vivo perfusion. This approach creates an opportunity to modify the graft before transplantation while potentially limiting systemic exposure in the recipient.

Clinical Outcomes in Reconstructive Transplantation

Our clinical research examines the long-term outcomes of face and upper-extremity transplantation. Areas of investigation include graft survival, acute and chronic rejection, immunosuppressive strategies, sensory and motor recovery, functional outcomes, and patient-reported outcomes.

By connecting observations from VCA recipients with findings from experimental models, we aim to identify clinically relevant questions that can be investigated in the laboratory and ultimately translated back into improved transplantation strategies.