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University of Bern

University of Bern, Switzerland

Main Areas of Interest

Organ transplantation is a proven therapy for the treatment of end stage solid organ failure involving, but not limited to heart, kidney, liver and lung. The success of solid organ transplantation has led several clinical teams to apply this technology to patients with nonreconstructable injuries such as severe burns or limb amputation. This therapy is now known as Vascularized Composite Allografts (VCA). VCA refers to the transplantation of multiple tissues such as muscle, bone, nerve and skin, as a functional unit (e.g. a hand, or face) from a donor to a patient in need of such therapy. These grafts serve as potential replacements for traumatic tissue losses such as those resulting in limb loss from explosive devices, accidents with farm machinery, burns or other major injuries. VCAs have limited ischemia time (cannot be processed or stored), require rapid re-establishment of blood flow, and donor-recipient matching, thus sharing identical issues with transplanted organs rather than tissue (for which none of these stipulations apply).

Techniques You Will Learn

The Department of plastic, reconstructive and hand Surgery of the Inselspital Bern is conducting basic research activities in the field of Vascularized Composite Allotransplantation (VCA). VCA, particularly hand and face transplantations, have become valid reconstructive options for individuals suffering from injuries not amenable to traditional techniques. Currently, broader application of VCA is limited by the side effects of the lifelong immunosuppression required to avoid rejection. Our research focuses on the development of new therapies aimed at local drug delivery, in order to reduce toxicity and improve therapeutic outcomes. Using an in vivo model of VCA, we tested different drug delivery systems demonstrating that local immunosuppression can be used to prevent graft rejection reducing systemic toxicity. Currently, we are engaged in characterize the immunological mechanisms by which prolonged survival of VCA is achieved during locally delivered immunosuppression and in refine our drug delivery system in order to promote graft survival by controlling the immunological response to VCA.

Additionally, we are engaged in characterizing the process of lymphatic reconstitution and in understanding how this process influences graft rejection in VCA. We predict that specifically targeting the lymphatic system will promote immunoregulation across the different tissues of a VCA graft, providing new perspectives for the design of effective immunotherapies targeted towards VCA. The ultimate goal of our group is to develop therapeutic approach able to reduce or eliminate life-long immunosuppression, boosting the clinical adoption of VCA, and improving the wellness and overall quality of life of injured patients receiving reconstructive transplants.

In the lab we routinely perform:

1) Surgery and microsurgery in the rat models (i.e., hind limb transplantation, perforator flap, seroma)

2) Surgery in porcine models (i.e., myocardial infarction, hind limb amputation and replantation, peripheral nerve studies)

3) Clinical evaluations on the animal models (laser doppler, sonography, lymphatic visualization, etc.)

4) Immunological techniques for characterizing transplant rejection (Flow cytometry, immunofluorescence, confocal microscopy, in vitro proliferation assay, multiplex Luminex technology, ELISA, etc.)

5) Ex vivo and in vitro techniques to study endothelial cell activation (cell culture, cell-ELISA, microfluidics systems to assess endothelial cell response under flow, etc.)

6) Vascularised composite tissue engineering by perfusion decellularization and ex vivo re-celluarization

Curriculum

Can Be Customized

Accommodation

Try Airbnb

Fees and Program Logistics

This program has the following durations available:

Duration	Fee

Who Can Apply

Host Details

Host Name: Prof. Esther Vogelin and Prof. Radu Oleriu

Affiliation: University of Bern

Address: Inselspital, Bern University Hospital, University of Bern, Switzerland

Website URL: http://www.plastichandchirurgie.insel.ch/de/

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