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The Role of Tissue-Resident Donor T Cells in Rejection of Clinical Face Transplants

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Technical Report,30 Sep 2016,29 Sep 2018

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Brigham and Womens Hospital Boston United States

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Unlike solid organ transplants, face transplants have a unique immunological characteristic the presence of skin, which contains approximately 1 million T cellscm2. A full face transplant is 600-700 cm2 in size and therefore, contains approximately 600-700 million donor T cells. We proposed to study 1 whether donor T cells persist long-term within facial allografts following transplantation, 2 the relative contribution of donor vs. recipient T cells in face transplant rejection, and 3 whether pathogenic T cell clones are measurable in blood during episodes of rejection and could therefore serve as an early and personalized rejection biomarker. Using high throughput T-cell receptor sequencing of donor and recipient tissues, we found that donor T cells persisted within facial allograft after transplant and may contribute to early rejection episodes. Recipient T cells migrated into the allograft during rejection and over time became predominant. Clonally expanded T cells infiltrating the rejecting allograft were detected in peripheral blood, raising the possibility that the frequency of patient-specific T cell clones in blood may serve as a non-invasive and personalized rejection biomarker for rejection.

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  • Medicine and Medical Research

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