While both types of tissue grafts can produce similar results, the path to surgery and recovery can vary widely between allografts and autografts.

Every year, millions of people undergo tissue transplantation to replace and repair vital tissues like skin, bones, valves, vessels, and more. In fact, according to the Centers for Disease Control and Prevention (CDC), surgeons transplant roughly 2.5 million tissue grafts every single year.

The two primary types of tissue grafts used for transplantation are autografts and allografts. When someone receives a transplanted tissue from their own body, it’s known as an autograft. When a transplanted tissue comes from a donor, it’s called an allograft.

When it comes to allograft versus autograft for tissue transplantation, each type has pros and cons. Below, we’ll share what you need to know about the differences between these two types of grafts and cover some of the risks and benefits of each type.

Tissue transplantation, or tissue grafting, is a procedure in which surgeons replace diseased, damaged, or even missing tissue with healthy, transplanted tissue. Two types of tissue grafts are commonly used for tissue transplants:

  • Autograft: An autograft is a tissue graft that is taken from one part of a person’s body and transplanted into another part of their body.
  • Allograft: An allograft is a tissue graft that is taken from one person’s body and transplanted into someone else’s body.

According to the CDC, surgeons prepare roughly 3.3 million tissue grafts every year for transplantation, though only 2.5 million of them make it to actual transplant. Some of the most common types of tissue grafts are bones, tendons and ligaments, skin, heart valves, blood vessels, and corneas.

Many different types of tissue transplantations exist. Tissue grafting is extremely common in orthopedic surgeries, such as ACL reconstruction surgery or spinal fusion surgery.

Although both autografts and allografts have some risks, they are relatively safe and effective tissue graft options. Research from 2022 suggests that both types of grafts can lead to significant improvements in the lives of people who need tissue transplants.

Still, each type of tissue graft has some benefits that may make one option a better choice than the other for you.

Benefits of autograft transplants

An autograft contains tissue from your own body, so one of the primary advantages is that it matches the markers of your immune system. This reduces the risk that your immune system will reject it. It also decreases the risk of disease transmission from a tissue that’s not your own.

Because surgeons don’t need to sterilize or preserve autograft tissue, researchers have found that autografts are often stronger than allografts. This is important because it decreases the risk of reinjury to the tissue after surgery. The fact that these cells are typically still alive can also help with integration and improve how the tissues heal.

Plus, autograft tissue has no additional costs, whereas an allograft tissue can often increase surgical costs.

Benefits of allograft transplants

Statistics show that orthopedic surgeons transplant over 1 million allografts every year. These types of tissue grafts are generally sourced from cadavers as part of organ or tissue donation, though they can sometimes come from living donors.

One of the main benefits of using allograft tissue is that there’s no risk of damaging another part of the body, like with an autograft. Allograft tissue is also more abundant than autograft tissue, so there’s more tissue available for transplantation.

And because there’s no additional surgery to remove tissue from the body with an allograft, recovery often tends to be quicker. In a 2019 study comparing autografts with allografts for labral reconstructions, researchers found that allograft patients had higher patient satisfaction scores during recovery and follow-up.

Allograof tissues can also be processed before the surgery to add additional proteins. This can improve how well the tissue can integrate into the graft.

Just as autografts and allografts have different benefits, each type of transplant surgery has a few risks and drawbacks.

Drawbacks of autograft transplants

One of the main drawbacks of using autografts is that you can donate only a limited amount of tissue from your own body as a living donor. Because of this, autograft surgery may not be appropriate for every type of tissue transplantation.

There’s also an increased risk of injury, infection, and complications at the site of the donated tissue. Plus, this procedure requires additional surgery to take out the tissue itself, which damages the donation site and will increase overall recovery time.

Research also suggests that autografts may increase the risk that certain surgical procedures will not work. For example, one study from 2018 on autograft and allograft cranioplasties found that using an autograft for surgery was associated with a greater risk of surgical failure than using an allograft.

Drawbacks of allograft

When sourcing an allograft from a donor, the surgeon must take out the tissue quickly, then sterilize and preserve it until surgery. Because this process can cause a small amount of damage to the tissue, allografts often aren’t as strong as living autografts.

In addition, allografts come with a higher risk of infection and rejection, which can increase the time it takes for your body to recover. And because surgeons have to source allografts from deceased or living donors, the cost for the tissue itself can be quite high.

Some research also suggests that autografts are better than allografts for certain surgeries.

A 2020 research review found that allografts were significantly more likely than autografts to lead to graft failure in ACL reconstruction surgery, while another review from 2022 found that allografts had an increased risk of failure and need for multiple revisional surgeries in osteochondral (cartilage and bone) transplants.

Tissue transplantation varies in cost depending on several factors, such as the type of surgery, inpatient recovery time, insurance coverage, and more.

Yet, you should consider a few major cost factors when choosing an autograft or allograft transplant.

One factor is that the cost of an allograft can run upward of $10,000 or more, depending on the type of tissue being transplanted. In fact, a 2010 review found that the cost of using allograft tissue for ACL reconstruction surgery resulted in higher overall surgical costs than using autograft tissue.

That said, it’s also important to consider the “cost” of having an increased recovery time with autograft transplantation.

For example, additional time spent recovering can result in missed wages and other opportunity costs, which can increase the financial burden of surgery. Increased recovery time also results in increased medical costs ― which may offset the costs saved if you choose to use an autograft for your transplant surgery.

Did you know?

Autografts and allografts aren’t the only options. There’s also a procedure called a xenograft, where tissue is taken from an animal and transplanted into humans.

This is regularly done with bovine (cow) bone for dental surgeries, as well as the heart values of pigs or cows.

Autografts and allografts are two of the most commonly used grafts in tissue transplant surgery, and each has several benefits and risks.

Autograft tissue is taken from elsewhere in your body and used in the transplant. These transplants are stronger and have less risk of infection and rejection, but sourcing the tissue results in more surgery and sometimes even increased recovery time.

Allograft tissue is taken from a donor, either a cadaver or another living person. These transplants are more widely available and often result in a quicker recovery time, but they are more expensive and may increase the risk that the transplant will not work.

If you’re undergoing tissue transplantation, consider taking some time to discuss your options more in-depth with your doctor. By exploring the benefits and risks of each type of tissue graft with you, they can help you find the best option for your personal, medical, and financial needs.