Abstract
BACKGROUND: Citation analysis is a useful bibliometric tool to identify impactful publications and trace the evolution of a specialty or a technique. In the past three decades, the research on vascularized composite allotransplantation (VCA) has grown exponentially but very few studies have examined the most influential papers in this field. METHODS: The Web of Science Core Collection database was searched for articles published from inception to August 4th, 2025. Titles, full authors' names, years of publication, source journals, regions of origin, and numbers of citations were recorded. VCA anatomical location, main topics, and citation density were determined. Articles were ranked based on number of citations and citation density; they were then categorized based on methodology, study design, and main topic. RESULTS: The 100 most-cited articles on VCA were published between 1996 and 2018 with the number of citations per article ranging from 61 to 604 citations. There were 53 non-clinical studies, the most prevalent topics were outcomes and rehabilitation (n = 48 articles) and immunology (n = 37). Of the 75 studies evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence, most (n = 51) were classified as level 4. DISCUSSION: This list of the top 100 most-cited articles highlights seminal and influential papers in VCA. It also demonstrates the relative novelty of this field with ongoing efforts in immunological research to allow its further expansion. The present study provides an understanding of VCA evolution while directing future clinical and preclinical studies.