autograft

An autograft is a tissue graft taken from one location on a patient and transplanted to another location in the same patient. It is distinguished from allografts (derived from another person) and xenografts (derived from another species). Autografts are favored because they are inherently histocompatible, contain living cells, and carry growth factors, reducing the risk of immune rejection and disease transmission.

Common autograft tissues include bone grafts, skin grafts, and fat grafts. In orthopedic and maxillofacial procedures, autologous bone grafts are typically harvested from the iliac crest, tibia, or fibula and used to fill defects or support fusions. Corticocancellous grafts provide structural support, while cancellous grafts promote rapid revascularization. In reconstructive surgery, autologous skin grafts (split-thickness or full-thickness) are used to cover wounds, with trade-offs between donor-site morbidity and graft durability. Autologous fat grafts are employed for soft tissue augmentation, with outcomes influenced by harvest and processing methods. Tendon, nerve, and other connective tissue autografts are also used in select procedures.

Advantages of autografts include lack of immune rejection, absence of disease transmission from donor to recipient, and the presence of viable osteogenic cells and growth factors. Disadvantages include donor-site morbidity, limited tissue availability, and potential donor-site pain or infection.

Alternatives include allografts, xenografts, and synthetic or biologic substitutes. Autografts remain a standard option when feasible, offering reliable integration and function but at the cost of an additional surgical site.