Vijay S. Gorantla

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A commentary on Mesenchymal stem cells are short-lived and do not migrate beyond the lungs after intravenous infusion Mesenchymal stromal cells (MSCs) are under investigation for clinical application. Despite approval by the United States Food and Drug Administration for MSC use in pediatric steroid-refractory acute GvHD after allogeneic hematopoi-etic stem(More)
Conventional breast cancer extirpation involves resection of parts of or the whole gland, resulting in asymmetry and disfiguration. Given the unsatisfactory aesthetic outcomes, patients often desire postmastectomy reconstructive procedures. Autologous fat grafting has been proposed for reconstructive purposes for decades to restore form and anatomy after(More)
Reconstructive transplantation has emerged as clinical reality over the past decade. Long-term graft acceptance has been feasible in extremity and facial vascularized composite allotransplantation (VCA) under standard immunosuppression. Minimizing overall burden of lifelong immunosuppression is key to wider application of these non-life saving grafts.(More)
The emerging field of vascular composite allotransplantation (VCA) has become a clinical reality. Building upon cutting edge understandings of transplant surgery and immunology, complex grafts such as hands and faces can now be transplanted with success. Many of the challenges that have historically been limiting factors in transplantation, such as(More)
The immunomodulatory potential of cell therapies using adipose-derived stem cells (ASCs) and bone marrow-derived mesenchymal stem cells (BM-MSCs) has been studied in vascularized composite allotransplantation (VCA). Most cell therapy-based experimental and clinical protocols integrate some degree of recipient conditioning/induction with antibodies or other(More)
Skin is the most immunogenic component of a vascularized composite allograft (VCA) and is the primary trigger and target of rejection. The skin is directly accessible for visual monitoring of acute rejection (AR) and for directed biopsy, timely therapeutic intervention, and management of AR. Logically, antirejection drugs, biologics, or other agents(More)
Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from(More)
retrograde IMV except one patient who used the IMV and an IMV perforator. Over the time period, there was an increasing use of perforator DIEP and SIEA flaps as well as the use of the IMV as recipients. Complications included delayed wound healing (n=5), abdominal bulge (n=2), cellulitis (n=3), seroma (n=2), and fat necrosis (n=3). There was one partial(More)
Fasciocutaneous flaps were favored for foot wounds (p<0.01), whereas muscle flaps were favored for tibial wounds (p<0.01), Gustilo grade IIIb injuries (p<0.01), and wounds with exposed hardware/bone/tendon (p=0.03). Intraoperatively, fasciocuta-neous flaps were associated with lower estimated blood loss (p<0.01). Increasing 17-year trends were noted in the(More)
Impaired nerve regeneration and inadequate recovery of motor and sensory function following peripheral nerve repair remain the most significant hurdles to optimal functional and quality of life outcomes in vascularized tissue allotransplantation (VCA). Neurotherapeutics such as Insulin-like Growth Factor-1 (IGF-1) and chondroitinase ABC (CH) have shown(More)