The evolution of composite tissue allotransplantation: The twentieth century realization of cosmas and damian

The purpose of this article is to review the historical background and clinical status of composite tissue allotransplantation and to discuss the scientific evolution of composite tissue allotransplantation. Composite tissue allotransplantation rapidly progressed in the 1980s with the discovery of cyclosporine. Although most success has been achieved with hand transplantation, others have made progress with allografts of trachea, peripheral nerve, flexor tendon apparatus, vascularized knee, larynx, abdominal wall, and most recently, partial face. As a symbol of great success, the world's first partial face allotransplantation occurred in November 2005 in France. In April 2006, the second was performed in China. There are now multiple institutions with plans to attempt the world's first full facial/scalp transplant. Composite tissue allotransplantation offers a viable alternative for unfortunate individuals suffering severe disfigurement and is a product of many decades of experimental research, beginning with rat hindlimb allografts.