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Surgical planning in virtual reality: a systematic review
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We just published a review on surgical planning in VR in the Journal of Medical Imaging. In the systematic review we look into how virtual reality (VR) is transforming surgical planning. With VR physicians can assess patient-specific image data in 3D, enhancing surgical decision-making and spatial localization of pathologies. We found that benefits of VR become more evident. However, its application in surgical planning remains experimental, with a need for refined study designs, improved technical reporting, and enhanced VR software usability for effective clinical implementation. Authors of "Surgical planning in virtual reality: a systematic review" are Prof. Dr. Moritz Queisner and Karl Eisenträger.

Virtual reality (VR) technology has emerged as a promising tool for physicians, offering the ability to assess anatomical data in 3D with visuospatial interaction qualities. This systematic review aims to provide an up-to-date overview of the latest research on VR in the field of surgical planning.
A comprehensive literature search was conducted based on the preferred reporting items for systematic reviews and meta-analyses covering the period from April 1, 2021 to May 10, 2023. The review summarizes the current state of research in this field, identifying key findings, technologies, study designs, methods, and potential directions for future research. Results show that the application of VR for surgical planning is still in an experimental stage but is gradually advancing toward clinical use. The diverse study designs, methodologies, and varying reporting hinder a comprehensive analysis. Some findings lack statistical evidence and rely on subjective assumptions. To strengthen evaluation, future research should focus on refining study designs, improving technical reporting, defining visual and technical proficiency requirements, and enhancing VR software usability and design. Addressing these areas could pave the way for an effective implementation of VR in clinical settings.
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Our manuscript "Depletion of donor dendritic cells ameliorates immunogenicity of both skin and hind limb transplants" has been accepted for publication in Frontiers in Immunology, section Alloimmunity and Transplantation. Authors are Muhammad Imtiaz Ashraf, Joerg Mengwasser, Anja Reutzel-Selke, Dietrich Polenz, Kirsten Führer, Steffen Lippert, Peter Tang, Edward Michaelis, Rusan Catar, Johann Pratschke, Christian Witzel, Igor M. Sauer, Stefan G. Tullius, and Barbara Kern.

Acute cellular rejection remains a significant obstacle affecting successful outcomes of organ transplantation including vascularized composite tissue allografts (VCA). Donor antigen presenting cells (APC), particularly dendritic cells (DC), orchestrate early alloimmune responses by activating recipient effector T cells. Employing a targeted approach, we investigated the impact of donor-derived conventional DC (cDC) and APC on the immunogenicity of skin and skin-containing VCA grafts, using mouse models of skin and hind limb transplantation.
By post-transplantation day 6, skin grafts demonstrated severe rejections, characterized by predominance of recipient CD4 T cells. In contrast, hind limb grafts showed moderate rejection, primarily infiltrated by CD8 T cells. While donor depletion of cDC and APC reduced frequencies, maturation, and activation of DC in all analysed tissues of skin transplant recipients, reduction in DC activities was only observed in the spleen of hind limb recipients. Donor cDC and APC depletion did not impact all lymphocyte compartments but significantly affected CD8 T cells and activated CD4 T in lymph nodes of skin recipients. Moreover, both donor APC and cDC depletion attenuated the Th17 immune response, evident by significantly reduced Th17 (CD4+IL-17+) cells in the spleen of skin recipients and reduced levels of IL-17E and lymphotoxin-α in the serum samples of both skin and hind limb recipients. In conclusion, our findings underscore the highly immunogenic nature of skin component in VCA. The depletion of donor APC and cDC mitigates the immunogenicity of skin grafts while exerting minimal impact on VCA.

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