Traumatic injuries and cancer resection resulting in large volumetric soft tissue loss leads to functional deficits and requires surgical reconstruction. Vascular composite allotransplantation (VCA) is an emerging reconstructive option that transfers multiple, complex tissues as a whole subunit from donor to recipient.

Many conditions do not have acceptable solutions: significant facial deformities that cannot be satisfactorily reconstructed, even with current advanced techniques; abdominal wall deficiencies may limit potential small bowel allotransplantation; traumatic loss of the extremities is particularly challenging to reconstruct; current techniques fall short of successful reconstruction for patients with tracheolaryngeal defects, uterine anomalies negating the possibility of childbirth. VCA also allows for the improvement of techniques for monitoring rejection in solid organ transplants.

Although promising, VCA is limited by significant immunosuppressive requirements. The use of engineered tissues can potentially address these issues and help to reduce toxicity from immunosuppression. These bioengineering techniques vary and range from acellular scaffolds to gene therapy to bioprinting. All of these therapies have the goal to reduce the risks of VCA-associated immunotherapies, preservation technologies impacting immune response, novel approaches for immune tolerance, validation of peripheral biomarkers to assess acute and chronic rejection, identify differences between VCA and solid organ transplantation and ex vivo techniques to extend timeline between procurement and transplantation.

In this special collection, we invite scientists with research relevant to the fabrication and testing of engineered skin tissues, to publish their techniques as JoVE articles.