Introduction: Despite the clinical success in vascularized composite allotransplantation (VCA), systemic immunosuppression remains necessary to prevent allograft rejection.Conclusion: Despite the demonstrated feasibility of VCA in recent years, continued im?provements to immunomodulatory strategies using tools like clustered regularly inter?spaced short palindromic repeats/Cas9 could lead to the development of approaches that mitigate the limitations associated with rejection of this life-giving procedure.a 2023 Elsevier Inc.In this context, genomic editing has emerged as a potential tool to minimize the need for toxic immunosuppressive regimens and has gained attention in the fields of solid organ transplantation and xeno?transplantation.All rights reserved.