Vascular composite allotransplantation (VCA) is a field under research and has emerged as an alternative option for the repair of severe disfiguring defects that result from infections or traumatic amputation in a selected group of patients. VCA is performed in centers with appropriate expertise, experience and adequate resources to effectively manage the complexity and complications of this treatment. Lifelong immunosuppressive therapy, immunosuppression associated complications, and the effects of the host immune response in the graft are major concerns in VCA. VCA is considered a quality of life transplant and the risk-benefit ratio is dissimilar to life saving transplants. Belatacept seems a promising drug that prolongs patient and graft survival in kidney transplantation and it could also be an alternative approach to VCA immunosuppression. In this review, we are summarizing current literature about the role of costimulation blockade, with a focus on belatacept in VCA.

血管复合同种异体移植（VCA）是一个正在研究的领域，并已成为修复特定患者群体因感染或创伤性截肢而导致的严重毁容缺陷的替代选择。VCA 在具有适当专业知识、经验和足够资源的中心进行，以有效管理这种治疗的复杂性和并发症。终生免疫抑制治疗、免疫抑制相关并发症以及移植物中宿主免疫反应的影响是 VCA 的主要关注点。VCA 被认为是一种提高生活质量的移植，其风险效益比与挽救生命的移植不同。Belatacept 似乎是一种有前途的药物，可以延长肾移植中患者和移植物的存活率，并且它也可能是 VCA 免疫抑制的替代方法。在这篇综述中，我们总结了有关共刺激阻断作用的现有文献，重点关注贝拉西普在 VCA 中的作用。