Composite Tissue Transplantation, Vol. 2 Book

The book contains black-and-white illustrations.

John Bosman

This text provides an overview of the increasingly visible field of composite tissue transplantation. In addition to providing a review of selected experimental research, it includes background information in basic immunobiological principles pertinent to this subject, as well as a discussion of topics relevant to clinical applications of this research. The purpose, as described by the editors, is to provide a basis for those already involved as well as for investigators interested in entering this field of research. Given the recent coverage in the news media of human cadaveric hand allotransplantation, such a text seems particularly timely as well as warranted. As the first investigators to publish long term success in composite tissue allotransplantation (CTA) using cyclosporin A seventeen years ago, the editors are among the most recognized and prolific investigators in this field. Individuals in the field of transplantation are targeted. Though explanation of basic immunobiology does appear in several of the chapters, in general this book requires some background understanding of principles of basic and transplant immunology. This text is essentially a compilation of the research of selected investigators in the field. Several pertinent subjects are addressed, including features unique to CTA: chimerism, graft-versus-host disease, the concept of variable immunogenicity, and strategies to induce donor-specific tolerance. Individual subjects are punctuated by graphic illustrations, and an appendix is useful in cross-referencing several works. Unfortunately, as is often the case in compilations, much of the text of this volume is given to redundancy. Though almost all of thestudies to date in CTA are mentioned at some point within the text of the individual chapters, an overall lack of organization makes a coherent understanding of the current state or future direction of CTA difficult. The editors, perhaps wisely, make no attempt to overtly argue for or against clinical trial, though mention is made of this in the preface. In fact, contributors provide support both for and against translation of this research into humans at this time. Finally, an objective presentation of important ethical issues raised by this subject would be a critical component of a text designed to provide a basis for understanding in this relatively new and fascinating field of research.