Abstract
Vascularized composite allotransplantation (VCA) enables functional and aesthetic reconstruction after complex tissue loss but remains limited by donor scarcity and immunosuppression. Xenotransplantation, using tissues from other species, offers a potential solution. While progress in solid organ xenografts has accelerated, vascularized composite xenotransplantation (VCX) remains largely experimental. This study presents the first systematic review of VCX, tracing its development over the past century and preclinical efforts to overcome immunologic and technical barriers. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines searched PubMed, EMBASE, Cochrane, Web of Science, and Google Scholar for English-language VCX studies. Methodological quality was assessed using the Newcastle-Ottawa Scale, SYRCLE Risk of Bias tool, and Oxford Levels of Evidence. Of 257 records, six preclinical studies (1885–2023) met inclusion criteria. Donor species included pigs, rabbits, dogs, and humans; recipients were rodents or nonhuman primates. Most used heterotopic grafts (e.g., limbs, groin flaps, thymosternal blocks) combining skin, muscle, bone, and nerves. Techniques included cryopreservation, microsurgical anastomosis, and genetically modified pig grafts (e.g., GalTKO.hCD46). All demonstrated short-term survival without long-term function. Despite technical feasibility, VCX remains experimental. Advances in gene editing, immune modulation, and tissue engineering are essential for clinical translation and may ultimately redefine reconstructive transplantation.
Keywords
Introduction
The field of reconstructive transplantation is experiencing a paradigm shift, propelled by scientific breakthroughs that are redefining the boundaries of tissue and organ replacement. Vascularized composite allotransplantation (VCA), the transplantation of complex anatomical units such as hands, faces, and limbs, has emerged over the past two decades as a transformative option for patients with devastating tissue loss1–5. Despite its promise, the widespread adoption of VCA remains constrained by one of the most formidable challenges in transplantation: donor–recipient matching and immunologic compatibility6–8. In this context, xenotransplantation, the transplantation of organs or tissues from nonhuman species, has re-entered the scientific spotlight as a compelling frontier with the potential to radically expand the donor pool and overcome current limitations in allograft availability9,10.
Originally explored in the context of solid organ replacement, xenotransplantation has evolved from a theoretical solution to an area of active research, with significant developments in genetic engineering, immunosuppression, and pathogen control fueling its revival11–13. Although applying xenotransplantation to VCA may initially seem counterintuitive, given that VCA is often pursued for anatomical and aesthetic restoration rather than life-sustaining function, it might open new reconstructive possibilities. In particular, xenogeneic grafts may hold potential in functionally critical tissue reconstructions, such as bone, muscle, or nerve. As technologies advance and immunologic barriers are better managed, the scope of xenografting may expand beyond traditional expectations, offering novel solutions for patients with complex reconstructive needs who currently lack timely access to suitable human donors. Herein, recent advances in Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-based gene editing and porcine genome modification have accelerated the generation of donor animals that exhibit reduced immunogenicity and minimized risk of zoonotic transmission14–16. While these innovations have largely been tested in the realm of cardiac and renal xenografts, their implications for composite tissue transplantation are increasingly being recognized, especially in areas such as burn care, where xenogeneic skin substitutes have long served as temporary wound coverage and continue to inspire novel approaches to skin reconstruction10,17. VCA presents a unique set of biological, immunologic, and aesthetic challenges, including the need for functional neuromuscular integration, skin viability, and long-term graft survival—issues that are magnified when crossing species barriers18–22.
Central to the promise of vascularized composite xenotransplantation (VCX) is the development of immunologically humanized animal models and bioengineered tissues capable of sustaining vascular and neural continuity. Encouraging preclinical studies have demonstrated partial success in achieving graft perfusion, temporary immune accommodation, and structural integration of xenogeneic tissues23–25. However, this emerging field is accompanied by substantial ethical, immunologic, and regulatory complexities. VCX carries risks not only of acute and chronic rejection but also of psychological acceptance and public health concerns related to cross-species disease transmission26–28.
Given these multifaceted challenges and recent momentum in xenotransplantation research, a comprehensive examination of the current evidence is both timely and necessary. This systematic review seeks to synthesize the latest advances in xenotransplantation as applied to vascular composite allografts, with a focus on immunologic barriers, graft viability, bioengineering strategies, and translational readiness. It aims to illuminate the opportunities and obstacles that define this evolving field, and to provide an up-to-date reference for clinicians, researchers, and policymakers exploring the next generation of reconstructive transplantation. To our knowledge, this is the first and most comprehensive systematic review of VCX to date, tracing its development over the past century and analyzing preclinical efforts to overcome immunologic and technical barriers.
Methods
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines to ensure clarity, rigor, and completeness in reporting. Given the expected diversity in study designs and outcome measures, a narrative synthesis was chosen over a meta-analysis. The review protocol was registered in advance with PROSPERO (CRD420251107669).
Systematic search
A thorough literature search was performed across multiple databases, including PubMed/MEDLINE, EMBASE, the Cochrane Library, Web of Science, and the first 25 pages of Google Scholar, covering all relevant publications up to July, 2025. The search focused on two core concepts: “xenotransplantation” and “vascular composite allografts,” which were combined using the Boolean operator “AND.” To ensure a comprehensive strategy, appropriate synonyms and Medical Subject Headings 29 were included. Detailed search strings for each database are available in Supplementary Digital Content 1. Additional relevant studies were identified by reviewing the reference lists of included articles. Studies were eligible for inclusion if they explored the use, biological mechanisms, immunologic considerations, or therapeutic potential of xenotransplantation specifically in the context of VCAs. Eligible designs included clinical studies, preclinical animal models, and relevant in vitro experiments. Only peer-reviewed articles published in English with full-text access were considered to maintain consistency and reliability. Studies were excluded if they lacked original data (e.g., reviews), did not directly pertain to VCA, or addressed xenotransplantation in unrelated organ systems. Three reviewers independently screened the titles and abstracts, followed by full-text assessments. Any discrepancies were resolved through discussion with a senior reviewer. The full study selection process is illustrated in the PRISMA 2020 flow diagram (Fig. 1).
Prisma 2020 flowchart highlighting study workflow.
Quality assessment
The methodological rigor of all included studies was evaluated using established tools appropriate to their design. Clinical studies were appraised using the Newcastle-Ottawa Scale (NOS), which assesses study quality based on participant selection, group comparability, and the reliability of outcome measurements 30 . This scale allocates up to nine stars, with higher scores reflecting greater methodological strength and is specifically suited for observational designs, including cohort and case-control studies. For animal research, the SYRCLE Risk of Bias tool was applied to identify potential sources of bias across domains such as allocation, blinding, outcome assessment, and selective reporting. This framework is widely used for evaluating the internal validity of preclinical studies 31 . In addition, the overall strength of the body of evidence was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. High-level evidence such as randomized controlled trials and systematic reviews were classified as Level I, while animal and in vitro studies were rated according to their translational relevance and experimental robustness 32 . Comprehensive results of the quality assessments are provided in Supplementary Digital Content 2, 3, and 4.
Data extraction
To ensure accuracy and reduce potential bias, data extraction was performed independently by two reviewers using a blinded, standardized approach. For each study that met the inclusion criteria, the following key information was systematically collected: Digital Object Identifier, first author, study title, country or region of publication, publication year, study type, and sample size when applicable. For clinical investigations, additional data included recipient demographics (such as age and sex), follow-up duration, graft site, and details of the xenogeneic tissue used. In preclinical animal studies, information was recorded on the species and model type utilized. In vitro studies were documented with relevant experimental methodologies and conditions. Across all study types, data extraction included the nature of the xenotransplantation intervention (e.g., graft composition, donor species, and immunosuppressive regimens), methods of graft assessment, immune responses, functional outcomes, and primary study conclusions.
Results
The systematic search identified n = 257 (100%) records in total, with n = 6 studies (2.3%) meeting the inclusion criteria. The included studies were published between 1885 and 2023, spanning a period of 138 years. Notably, all six studies were in vivo experimental animal studies, and no clinical research was identified within the eligible results. As such, the NOS—typically used for assessing the quality of observational clinical studies—was not applicable to this review. Furthermore, all included studies were classified as Level 5 evidence according to the OCEBM Levels of Evidence, which corresponds to foundational or preclinical evidence. Quality assessment using the SYRCLE Risk of Bias tool revealed that most domains were rated as either “unclear” or “low” risk of bias, reflecting an overall low level of methodological rigor across the included studies. Further information is provided in Table 1 and Figure 2.
Study demographics.
DOI, digital object identifier; USA, United States of America; VCA, vascularized composite allotransplantation; NHPs, nonhuman primates; NSG, NOD scid gamma (immunodeficient mouse strain); GalTKO.hCD46, genetically modified pigs lacking α1,3-galactosyltransferase and expressing human CD46.
Overview of vascular composite xenotransplantation (VCX) donor–recipient species and transplant sites. This illustration highlights the diversity of donor–recipient combinations, graft locations, and experimental purposes within early VCX research.
Study demographics
The six included studies (n = 6, 100%) explored various VCXs using a diverse range of donor and recipient animal models. Donor species included rabbits, dogs, mice, pigs, nonhuman primates (NHPs), humans (tissue samples), and rats, while recipients consisted of humans, rats, rabbits, baboons, rhesus macaques, and immunodeficient NSG mice. Of the six studies, n = 5 (83.3%) employed heterotopic transplantation, where the grafts were implanted at the abdominal wall, groin, or neck. Only n = 1 (16.7%) study used an orthotopic approach, placing a rabbit eye into a human orbital cavity model. Donor sites varied according to graft type and species, including the eye, hind limb, anterior thorax, groin flap, and amputated human fingers. Recipient sites were equally diverse, ranging from extracorporeal vascularized setups to subcutaneous and anatomic implantation sites. VCX types included whole ocular globe blocks, musculoskeletal limbs, composite digital segments, thymosternal blocks, and groin flaps, each integrating multiple tissue types such as skin, muscle, vessels, bone, and, in some cases, nerves or immune tissues like the thymus. This variation underscores the experimental nature and early translational phase of VCX research.
Functional integration and early outcomes in VCX models
Across the six included studies (n = 6, 100%), VCX was explored through various in vivo models focusing on both technical feasibility and early biological outcomes. In the earliest reported attempt, Bradford et al. transplanted a rabbit eye orthotopically into a human orbital cavity. While the graft exhibited short-term vascular survival, motility, and cosmetic integration without infection, no visual recovery was achieved due to optic nerve degeneration. Similarly, Sher et al. conducted a heterotopic transplantation of 25 canine eyes onto rat femoral vessels, demonstrating immediate blood flow and vascular patency in all grafts, confirmed via fluorescein angiography. However, this was a short-term model (≤2 hours), and no long-term function or rejection data were collected.
Tanabe et al. developed a murine xenotransplant model of musculoskeletal VCX by grafting mouse hind limbs into rat abdominal pockets. Despite successful initial perfusion, all grafts (n = 10) were rejected by day 4, with histologic signs of vascular thrombosis and hemorrhage, consistent with humoral rejection mechanisms. This early rejection occurred without immunosuppression, highlighting the immunologic barriers specific to VCX across species. In a distinct approach, Bakhach et al. cryopreserved and transplanted human fingers (n = 3) into rabbit necks, achieving immediate revascularization and maintenance of tissue integrity for up to 5 days, despite lack of immunosuppression. However, survival was short-term, with two of three animals dying within days, and no functional assessment was possible. Overall, these investigations primarily demonstrated technical feasibility, including successful graft perfusion and implementation of microsurgical anastomotic techniques, while most study designs were too short to meaningfully assess immune responses or longer-term rejection patterns. An important exception was the occurrence of hyperacute (humoral) rejection episodes in select xenotransplant settings. Full insights are provided in Table 2.
Summary of immunosuppressive strategies, interventions, and outcomes in vascularized composite xenotransplantation studies.
DOI, digital object identifier; VCX, vascularized composite xenotransplantation; N/A, not applicable; IVC, inferior vena cava; DCAF, dichlorofluorescein acetate; mAb, monoclonal antibody; ATG, anti-thymocyte globulin; VCA, vascularized composite allotransplantation; CD, cluster of differentiation.
Immune modulation, cryopreservation, and translational feasibility
Sendil et al. introduced a thymosternal composite xenograft containing skin, muscle, bone, and thymic tissue sourced from genetically modified pigs (GalTKO.hCD46), which lack the α1,3-galactosyltransferase gene and express human CD46 to reduce hyperacute rejection. These grafts were transplanted into nonhuman primate recipients (female baboons and rhesus macaques) without immunosuppressive treatment to evaluate short-term feasibility. Although technical success in transplantation was achieved, grafts were terminated within 12 hours due to severe coagulation disturbances, likely related to interspecies incompatibility. This precluded long-term graft survival or tolerance assessment. In contrast, allotransplanted NHPs treated with anti-CD40 monoclonal antibody (2C10R4) and adjunct immunosuppressants such as methylprednisolone, mycophenolate mofetil, and ATG (in one case) survived up to 87 days, showing transient microchimerism via Y-chromosome tracking.
Finally, Zor et al. employed cryopreserved groin flaps from Sprague–Dawley rats transplanted into NSG (NOD scid gamma) immunodeficient mice (n = 6) using a staged VCX approach. Tissues were stored at −80°C following perfusion with preservation solution, then thawed and revascularized using microvascular anastomosis. The grafts exhibited preserved vascular integrity and histologic viability for up to 14 days, suggesting that immunodeficient models can isolate cryopreservation variables from immunologic rejection. This approach supports the possible development of xenogeneic tissue banking and may pave the way for future reconstructive applications where graft availability and timing are critical. Together, these studies underscore that while functional integration remains limited, advances in genetic engineering, tissue preservation, and immunologic research tools are positioning VCX for more meaningful translational breakthroughs. Full details are shown in Table 2.
Immunosuppression perspective of VCX
Across all studies included, no VCX model applied a full immunosuppressive regimen aimed at achieving long-term survival, let alone any tolerance induction regimen. Instead, most focused on short-term surgical feasibility, perfusion, tissue viability or the potential induction of immunotolerance. In Sendil et al., xenografts using genetically modified pig thymosternal grafts were transplanted into nonhuman primates without immunosuppression and terminated within 12 hours, with no immune tolerance achieved and graft failure attributed to severe coagulation disturbances. In contrast, allogeneic grafts in the same study, treated with a combination of anti-CD40 monoclonal antibody (2C10R4), methylprednisolone, mycophenolate mofetil, and—once—antithymocyte globulin (ATG), survived up to 87 days and exhibited transient microchimerism, but did not achieve full immunotolerance. Other studies, such as those by Tanabe et al. and Bakhach et al., similarly avoided immunosuppression to evaluate intrinsic graft viability or rejection kinetics, confirming rapid rejection within days. Meanwhile, Zor et al. bypassed immunologic rejection entirely by using immunodeficient NSG mice as recipients for cryopreserved xenogeneic flaps, allowing the isolated assessment of tissue preservation. Collectively, these findings underscore that, while functional xenograft survival remains unachieved, current models might lay the groundwork for future immunomodulatory strategies tailored to the unique challenges of VCX.
Discussion
VCX is gaining attention as a potential strategy to help donor–recipient matching in reconstructive transplantation, especially for complex tissue defects involving skin, muscle, bone, and nerves. Advances in gene editing, tissue preservation, and immunomodulation have renewed scientific interest in cross-species transplantation. However, VCX presents several challenges, including functional integration, immune rejection, and ethical considerations. This systematic review aims to consolidate current knowledge on VCX, highlighting key developments in immunologic barriers, graft viability, bioengineering approaches, and translational readiness to support future progress in the field.
Study findings
Overall, our review found that over a century of VCX research has produced six diverse preclinical studies employing techniques such as microsurgical vascular anastomosis, cryopreservation, and genetic engineering. Models ranged from early orthotopic rabbit-to-human eye transplants for cosmetic integration, to murine limb xenografts placed in rat abdominal pockets for studying acute rejection mechanisms. Other techniques included cryopreservation and revascularization of human fingers in rabbits, staged groin flap transfers from rats to immunodeficient mice, and transplantation of genetically modified pig thymosternal grafts into nonhuman primates. Across these studies, VCX was shown to be technically feasible, with several models achieving short-term vascular patency, tissue viability, or structural integration, though long-term survival, functional recovery, and immune tolerance remain largely unachieved. Moreover, VCX might offer potential clinical advantages, including reduced wait times, improved graft availability, and fewer ethical concerns compared to VCA, such as body restoration after donor procurement, where possible solutions, like 3D-printed masks for restoring the donor’s facial integrity, are debated33,34. Additionally, emerging approaches like decellularized xenografts and bioengineered skin substitutes may further enhance graft acceptance and customization in future applications 35 .
Comparison of study findings to literature
In the current biomedical literature, xenotransplantation occupies a rapidly evolving and highly interdisciplinary space, with recent advances positioning it as a promising, yet still experimental, solution to the critical shortage of donor tissues and organs. While the field of solid organ xenotransplantation—particularly kidney and heart transplants from genetically modified pigs—has progressed toward early clinical trials, VCX remains confined to preclinical animal models36–38. Here, VCX presents unique immunologic and technical challenges due to its inherent tissue complexity and21,39,40 each tissue type carries a distinct antigenic load and rejection profile, making coordinated immune regulation more difficult than in solid organ xenografts41,42. Furthermore, hyperacute rejection, driven largely by xenoreactive antibodies, and coagulopathy—especially in pig-to-primate models—continues to pose major obstacles in xenotransplantation43,44. Notably, while hyperacute rejection represents a major immunological barrier in solid organ xenotransplantation, it has, to our knowledge, not been reported in clinical vascularized composite allotransplantation, underscoring the uncertainty when extrapolating xenogeneic immune mechanisms to composite tissues. However, breakthroughs in gene editing, particularly CRISPR/Cas9 technology, have significantly altered the landscape. Donor pigs can now be engineered to delete xenoantigens such as α1,3-galactosyltransferase (Gal), Neu5Gc, and β4GalNT2, which are primary targets of pre-formed human antibodies. Simultaneously, insertion of human transgenes (e.g., CD46, thrombomodulin, and HLA-E) helps modulate complement activation, prevent coagulation disorders, and reduce NK cell-mediated cytotoxicity45–48. These modifications are already being applied in solid organ xenotransplantation and hold potential for composite tissues, although translating these gains to VCX remains understudied. Moreover, advances in tissue engineering and regenerative medicine are beginning to intersect with xenotransplantation. Decellularized xenogeneic scaffolds seeded with autologous cells may provide personalized, immunologically inert VCX substitutes49–51. Similarly, 3D bioprinting and organ-on-chip models are emerging as platforms to model and optimize immune responses in composite grafts before in vivo translation 52 . Cryopreservation protocols and vascular perfusion strategies are also improving, enabling graft storage and logistical flexibility without significant loss of tissue viability53–55. These advances are particularly important for staged VCX procedures and could revolutionize emergency reconstructive transplantation workflows. Yet, ethical concerns about animal welfare, zoonotic disease transmission, and long-term psychological impacts on recipients remain unresolved. Regulatory pathways are not yet clearly defined for composite xenografts, which combine multiple tissue types with varying risk profiles56–58. In sum, xenotransplantation research is expanding into VCX with increasing technical sophistication. Parallel developments in cross-species organ engineering, where human-compatible tissues and organs are generated or matured within animal hosts, are further transforming the field’s conceptual and technical landscape. By leveraging advances in stem cell technology, genome editing, and developmental bioengineering, this approach aims to create patient-specific grafts that overcome donor shortages and minimize immune rejection. Current progress suggests that VCX may hold greater near-term potential for applications in bone and muscle regeneration, while VCX involving skin and complex vascularized tissue remains more challenging due to issues such as immune rejection, vascular integration, and antigenic disparity. To address these barriers, innovations in gene editing, immunomodulation, cryopreservation, and tissue engineering are converging to improve both biological compatibility and logistical feasibility. Although still far from clinical translation, the combination of xenotransplantation and cross-species organ engineering is laying the foundational groundwork for a new generation of reconstructive solutions, one that could eventually render the concept of tissue donor shortages obsolete and redefine what is possible in personalized, regenerative reconstruction 59 .
Lookout, summary and takeaway
Overall, for patients VCX represents a bold and emerging frontier in reconstructive surgery, one that could eventually provide custom-tailored transplants such as hands, faces, or limbs without waiting for a human donor. While still in its experimental phase, early feasibility research has shown that tissues from animals, such as limbs, skin, or even immune-structuring organs, could potentially be transplanted into different species using advanced surgical, preservation, and genetic techniques. This offers hope for addressing the critical shortage of donor tissues, particularly in cases of complex trauma or congenital absence. For physicians, this review highlights over a century of foundational progress in VCX, with recent breakthroughs in porcine genome editing, immune modulation, and tissue preservation renewing momentum in the field. Donor animals are now being genetically engineered to reduce antigenicity and improve compatibility, while preclinical models are enabling exploration of graft survival without traditional immunosuppression. Notably, xenotransplantation is undergoing a paradigm shift from artisanal, one-mutation-at-a-time breeding methods—such as those used in the Sachs lab at Columbia’s CCTI—to a professionalized, high-throughput approach using CRISPR/Cas9 to create pigs with multiple precise genetic edits, as exemplified by companies like eGenesis 60 . However, despite technical successes and conceptual advances, VCX remains far from clinical application. Long-term graft survival, functional recovery, immune tolerance, and biosafety remain major barriers. Further research, both experimental and translational, is essential before VCX can be safely considered for clinical use. Lastly, an important consideration in VCX is the choice of donor source. Obtaining composite tissues from live animals rather than brain-dead human donors offers distinct advantages, such as greater availability, logistical flexibility, and the ability to precondition or genetically modify the donor in controlled settings. This could significantly reduce wait times and improve tissue matching. However, it also introduces substantial immunologic challenges, including stronger xenogeneic immune responses, higher risk of zoonotic disease transmission, and greater ethical concerns related to animal welfare and long-term biosafety. Unlike human donors, live animal donors may also require repeated harvesting protocols, raising additional questions about sustainability and regulation. As the field advances, carefully balancing these opportunities and challenges, alongside rigorous candidate selection, will be essential to responsibly guide VCX from experimental promise to clinical reality.
Limitations
This systematic review is constrained by several important limitations. Most notably, only six studies met the inclusion criteria, reflecting the early and experimental nature of VCX. This small sample size limits generalizability and prevents subgroup analysis by graft type, species, or intervention. All included studies were preclinical and conducted in animal models, which, while essential for foundational insight, limit direct applicability to human clinical settings due to species-specific immunological and anatomical differences. Most studies employed heterotopic grafting and short follow-up durations, providing limited data on long-term viability, functional recovery, or immune tolerance. There was substantial methodological heterogeneity across studies, including differences in donor species, graft composition, surgical approach, preservation techniques, and use of immunosuppression. While some employed advanced strategies such as gene editing (e.g., GalTKO.hCD46 pigs) or cryopreservation, others lacked these features, making comparisons difficult. Moreover, applications of tissue engineering and gene editing remain limited. Few studies explored decellularization, scaffold-based reconstruction, or in-depth immunologic analyses, leaving many mechanistic questions unanswered. Finally, the absence of clinical studies underscores the early stage of this field. No standardized protocols, outcome metrics, or regulatory frameworks currently exist to guide clinical translation, emphasizing the need for more robust and longitudinal research moving forward.
Conclusion
Over more than a century of scientific effort, VCX has evolved from isolated experimental attempts to a dynamic field at the intersection of reconstructive transplantation, immunology, and bioengineering. This review highlights that while VCX remains in its early stages, foundational studies have established proof of concept for technical feasibility across multiple graft types and species. Recent progress in gene editing, cryopreservation, and tissue engineering has opened new avenues to address longstanding challenges such as immunologic rejection, donor scarcity, and graft viability. Despite these advancements, clinical application of VCX is not yet within immediate reach. Long-term graft survival, immune tolerance, and functional integration remain unresolved. This discrepancy implies that immunological paradigms derived from solid organ xenotransplantation may not fully apply to composite grafts, emphasizing VCX as a conceptually distinct transplant entity rather than a simple extension of existing xenograft models. Moreover, ethical, regulatory, and biosafety concerns continue to pose significant barriers. Further translational research is essential to refine immunomodulatory strategies, enhance graft biointegration, and develop standardized models that can bridge the gap between experimental success and clinical implementation. As innovations continue to converge, VCX stands poised to become a potentially transformative option in reconstructive transplantation, one that may eventually alleviate the limitations of current allograft practices and offer new hope for patients with complex tissue loss.
Supplemental Material
sj-docx-1-cll-10.1177_09636897261431041 – Supplemental material for Vascularized composite xenotransplantation: Where we have been and where we could go?
Supplemental material, sj-docx-1-cll-10.1177_09636897261431041 for Vascularized composite xenotransplantation: Where we have been and where we could go? by Tobias Niederegger, Thomas Schaschinger, Gabriel Hundeshagen, Samuel Knoedler, Jule C. Brandt, Jan O. Voss, Max Heiland, Curtis L. Cetrulo, Alexandre G. Lellouch and Leonard Knoedler in Cell Transplantation
Footnotes
Acknowledgements
We acknowledge and thank BioRender for providing the platform used to create the graphical abstract and Fig. 2.
Ethical considerations
Not applicable.
Consent to participate
Not applicable.
Author contributions
Tobias Niederegger: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Validation, Visualization, Writing—original draft; Thomas Schaschinger: Data curation, Formal analysis, Methodology, Validation, Visualization, Writing—original draft; Gabriel Hundeshagen: Validation, Investigation, Resources, Writing —review & editing; Samuel Knoedler: Validation, Writing—review & editing; Jule Brandt: Data curation, Validation, Visualization, Writing—review & editing; Jan O. Voss: Investigation, Resources, Writing—review & editing; Max Heiland: Validation, Resources, Writing—review & editing; Curtis L. Cetrulo: Resources, Supervision, Writing—review & editing; Alexandre G. Lellouch: Conceptualization, Methodology, Project administration, Resources, Supervision, Writing—review & editing; Leonard Knoedler: Conceptualization, Methodology, Project administration, Resources, Supervision, Writing—review & editing.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data availability statements
Not applicable. All data included in this review are derived from previously published studies. The full search string is provided in the manuscript.
Declaration of AI
During the preparation of this work, the author(s) used AI to assist with language refinement, grammar correction, and stylistic improvements. After using this tool, the author(s) reviewed and edited the content as needed and take full responsibility for the content of the publication.
Statement of human and animal rights
This article does not contain any studies with human or animal subjects.
Statement of informed consent
There are no human subjects in this article and informed consent is not applicable.
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References
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