The Impact of Skin Type and Area on Skin Rejection in Limb Transplantation

Abstract

Atypical manifestation of skin rejection observed in a series of hand transplant recipients suggests that appearance and mechanisms of rejection may vary and depend on skin type and location. We herein characterize skin rejection and inflammation at 3 defined areas of a rat hind-limb allograft. Allograft skin was harvested at the thigh, dorsum and planta pedis on postoperative day 5 and analyzed for histopathology, T-cell composition and expression of cytokines associated with skin inflammation. Isografts and naïve animals served as controls. Histology of the allograft skin collected on day 5 showed a diffuse cell infiltrate in the dermis and at the dermal-epidermal interface in the thigh and dorsum, whereas in the planta pedis it was mainly located perivascularly in the dermis. At all areas, epidermal involvement such as apoptotic keratinocytes and infiltrating lymphocytes were observed. Isograft skin showed only very mild or no signs of inflammation at all 3 locations. No significant difference was obse...