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Linda Carime Cendales, MD

Director, Duke Vascularized Composite Allotransplantation Program
Chair, Diversity and Inclusion Committee
Associate Professor of Surgery
Associate Professor of 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

Publications

Erdmann, Detlev, Andrew Atia, Brett T. Phillips, Suhail K. Mithani, Yash J. Avashia, Beth A. Hollister, Linda C. Cendales, Kadiyala V. Ravindra, and Debra L. Sudan. “Small bowel and abdominal wall transplantation: A novel technique for synchronous revascularization..” Am J Transplant 19, no. 7 (July 2019): 2122–26. https://doi.org/10.1111/ajt.15370.

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Cherikh, Wida S., Linda C. Cendales, Christopher L. Wholley, Jennifer Wainright, Vijay S. Gorantla, David K. Klassen, Sue V. McDiarmid, and Lawrence Scott Levin. “Vascularized composite allotransplantation in the United States: A descriptive analysis of the Organ Procurement and Transplantation Network Data..” Am J Transplant 19, no. 3 (March 2019): 865–75. https://doi.org/10.1111/ajt.15062.

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Weissenbacher, Annemarie, Linda Cendales, Emmanuel Morelon, Palmina Petruzzo, Gerald Brandacher, Peter J. Friend, Vijay Gorantla, et al. “Meeting Report of the 13th Congress of the International Society of Vascularized Composite Allotransplantation..” Transplantation 102, no. 8 (August 2018): 1250–52. https://doi.org/10.1097/TP.0000000000002207.

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Cendales, Linda C., David S. Ruch, Adela R. Cardones, Guy Potter, Joshua Dooley, Daniel Dore, Jonah Orr, et al. “De novo belatacept in clinical vascularized composite allotransplantation..” Am J Transplant 18, no. 7 (July 2018): 1804–9. https://doi.org/10.1111/ajt.14910.

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Zhu, M., K. Samy, L. Lin, J. Wang, L. Cendales, A. Kirk, A. Barbas, and T. Brennan. “Donor Deficiency of RIP3 Phosphokinase Activity Shortens Cardiac Allograft Survival in the Setting of Costimulation Blockade..” In American Journal of Transplantation, 18:248–248. WILEY, 2018.

Scholars@Duke

Wainright, J., L. Levin, L. Cendales, C. Wholley, W. Cherikh, D. Klassen, and B. Pomahac. “Facial Allotransplantation: An Early Look at OPTN Data..” In American Journal of Transplantation, 18:760–760. WILEY, 2018.

Scholars@Duke

Lin, L., J. Wang, L. Cendales, A. Kirk, and T. Brennan. “In Vivo Allograft Exposure to Mitochondrial DAMPs Prior to Organ Procurement Increases Graft Rejection in Mice..” In American Journal of Transplantation, 18:500–500. WILEY, 2018.

Scholars@Duke

Wainright, J., L. Levin, C. Wholley, W. Cherikh, D. Klassen, and L. Cendales. “Upper Limb Transplantation in the US: An Early Look at OPTN Data..” In American Journal of Transplantation, 18:759–759. WILEY, 2018.

Scholars@Duke

Zheng, H. B., B. Watkins, V. Tkachev, S. Yu, D. Tran, S. Furlan, K. Zeleski, et al. “The Knife's Edge of Tolerance: Inducing Stable Multilineage Mixed Chimerism but With a Significant Risk of CMV Reactivation and Disease in Rhesus Macaques..” Am J Transplant 17, no. 3 (March 2017): 657–70. https://doi.org/10.1111/ajt.14006.

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