Re: can local immusupression be given after cadaveric hand transplant?

The first cadaveric hand transplant was done in 1999. Other transplants have followed this one. Systemic immunosuppressant (methylprednisolone) is necessary to combat rejection, since there is no way to deliver a local immunosuppressant on a continuous basis. The reason for this is because the patient's T-cells (which can cause allograft rejection) circulate throughout the allograft and will recognize foreign cells at any point within the transplant. However, topical immunosuppressants (tacrolimus and clobetasol) are used to lessen the impact of rejection of the skin of the allograft.

References

1. Dubernard, Jean-Michel; Owen, Earl; Herzberg, Guillaume; Lanzetta, Marco; Martin, Xavier; Kapila, Hari; Dawahra, Marwan; Hakim, Nadey S. Human hand allograft: report on first 6 months. The Lancet 353 (9161): 1315-132017 April 1999
2. Jones JW. Gruber SA. Barker JH. Breidenbach WC. Successful hand transplantation. One-year follow-up. Louisville Hand Transplant Team [see comments]. New England Journal of Medicine 343(7):468-73, 2000 Aug 17.