Skip to main content

Linda Carime Cendales, MD

Director, Duke Vascularized Composite Allotransplantation Program
Associate Professor of Surgery
Associate Professor in Orthopaedic Surgery
Office: 129 Baker House, Durham, NC 27710
Campus Mail: DUMC DUMC Box 3181, Durham, NC 27710

Vascularized composite allotransplantation (VCA) refers to the transplantation of multiple tissues, such as skin, muscle, tendon, nerve, and/or bone, as a functional unit (e.g. a hand, an abdominal wall). Several recent advances in clinical organ transplant immunosuppression and experimental VCA have now made it feasible to consider clinical VCA for functional restoration in patients with the loss of one or both hands or large tissue defects that may not be reconstructed with autologous tissue. My research facilitates the translation of VCA from the bench to the bedside.

Our group has established preclinical models to understand VCA rejection in different tissues and to use that insight to minimize immunosuppression in VCA recipients who participate in clinical trials. We also organized the first public international consensus discussions conference in VCA at the Ninth Banff Conference on Allograft Pathology in Spain in 2007 resulting in the Banff VCA 2007 classification for skin allograft pathology. Additionally, we established a VCA Consortium to enable the comprehensive analysis of samples from patients in VCA clinical trials around the country.

Based on our studies of different immunosuppressive regimens in primates, we have been the first to show that belatacept prevents rejection in VCA in primates and controls rejection in humans. We are currently investigating this approach in a clinical trial of hand transplant recipients (NCT02310867). This clinical trial aims to determine the safety and efficacy of hand transplantation as a treatment for patients with limb loss. This study will also test the efficacy of belatacept to prevent rejection of the transplanted hand. We are also currently investigating in a clinical trial the efficacy of abdominal wall transplantation for the reconstruction of abdominal wall defects (NCT03310905).

Education and Training

  • Fellow, Translational Research, Emory University School of Medicine, 2009 - 2011
  • Senior Clinical Fellow, National Institutes of Health, 2004 - 2006
  • Fellow, Transplantation Surgery, National Institutes of Health, 2001 - 2004
  • Clinical Fellow & Senior Fellow, Hand & Microsurgery, Christine M. Kleinert Institute, 1997 - 2001
  • Chief Resident, Surgery, Hospital General Dr. Manuel Gea Gonzalez (Mexico), 1995 - 1996
  • Internship/Junior Resident, Surgery, Hospital General Dr. Manuel Gea Gonzalez (Mexico), 1993 - 1995
  • M.D., Universidad Autonoma Metropolitana (Mexico), 1992


Smith, Patrick J., Guy Potter, Maria Manson, Michael Martin, and Linda C. Cendales. “Psychosocial considerations in the assessment of hand transplant candidates: A single-center experience and brief literature review.” Clin Transplant 35, no. 4 (April 2021): e14268.

Full Text

Moris, Dimitrios, Jun Wang, Maria Angelica Selim, Mingqing Song, Linda Stempora, William Parker, Allan D. Kirk, and Linda C. Cendales. “Vascularized composite allotransplants as a mechanistic model for allograft rejection - an experimental study.” Transpl Int 34, no. 3 (March 2021): 572–84.

Full Text

Mosca, P. J., S. Zani, M. M. Haglund, B. H. Collins, S. Wasiolek, T. N. Pappas, A. D. Kirk, and L. C. Cendales. “The Legacy of Joseph A. Moylan, M.D.: "it's about Everyone Else".” Annals of Surgery, January 1, 2021.

Full Text

Lewis, Holly C., and Linda C. Cendales. “Vascularized composite allotransplantation in the United States: A retrospective analysis of the Organ Procurement and Transplantation Network data after 5 years of the Final Rule.” Am J Transplant 21, no. 1 (January 2021): 291–96.

Full Text

Wang, Jun, Jianxuan Wu, Dimitrios Moris, Byron Hayes, Soman N. Abraham, and Linda C. Cendales. “Introducing a novel experimental model of bladder transplantation in mice.” Am J Transplant 20, no. 12 (December 2020): 3558–66.

Full Text

Atia, Andrew, Dimitrios Moris, MacKenzie McRae, Mingqing Song, Linda Stempora, Francis Leopardi, Kyha Williams, et al. “Th17 cell inhibition in a costimulation blockade-based regimen for vascularized composite allotransplantation using a nonhuman primate model.” Transpl Int 33, no. 10 (October 2020): 1294–1301.

Full Text

Hein, Rachel E., David S. Ruch, Christopher S. Klifto, Fraser J. Leversedge, Suhail K. Mithani, Tyler S. Pidgeon, Marc J. Richard, and Linda C. Cendales. “Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database.” Am J Transplant 20, no. 5 (May 2020): 1417–23.

Full Text

Moris, D. P., A. Atia, M. Rae, M. Song, L. Stempora, F. Leopardi, K. Williams, et al. “Th17 Cell Inhibition in a Costimulation Blockade Based Regimen for Vascularized Composite Allotransplantation Using A Non-Human Primate Model.” In American Journal of Transplantation, 20:537–537, 2020.