Vascularized composite allotransplants (VCAs) have unique properties because of diverse tissue components transplanted en mass as a single unit. In addition to surgery, this type of transplant also faces enormous immunological challenges that demand a detailed analysis of all aspects of alloimmune responses, organ preservation, and injury, as well as the immunogenicity of various tissues within the VCA grafts to further improve graft and patient outcomes. Moreover, the side effects of long-term immunosuppression for VCA patients need to be carefully balanced with the potential benefit of a non-life-saving procedure. In this review article, we provide a comprehensive update on limb and face transplantation, with a specific emphasis on the alloimmune responses to VCA, established and novel immunosuppressive treatments, and patient outcomes.

血管化复合同种异体移植（VCA）具有独特的特性，因为多种组织成分作为一个整体进行移植。除手术外，此类移植还面临着巨大的免疫学挑战，需要详细分析同种免疫反应、器官保存和损伤等各个方面，以及VCA移植物内各组织的免疫原性，以进一步改善移植物和患者的健康状况。结果。此外，需要仔细权衡 VCA 患者长期免疫抑制的副作用与非挽救生命手术的潜在益处。在这篇综述文章中，我们提供了肢体和面部移植的全面更新，特别强调了对 VCA 的同种免疫反应、已建立的和新型的免疫抑制治疗以及患者的结果。