A review of the world’s published face transplant cases: ethical perspectives

Theodorakopoulou, Evgenia; Meghji, Sheneen; Pafitanis, Georgios; Mason, Katrina

doi:10.1177/2059513117694402

Cited by 24 publications

(33 citation statements)

References 54 publications

(100 reference statements)

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“…The first stage coincides with initial scientific attempts when we ask ‘what can we do?’ As advances occur, the question shifts to ‘what should we do?’ This is demonstrated by the increase in publications and the establishment of a regulatory ethics framework after the first clinical achievement in 2011 . This question gains more importance when the procedure is not life‐saving but life‐enhancing, such as face and upper extremity transplantation, which have, and continue to face, similar ethical challenges as they become more successful . During these early stages, the principle of nonmaleficence dominates, a trend that is also reflected in the upper extremity and face transplantation literature .…”

Section: Discussionmentioning

confidence: 99%

The changing paradigm of ethics in uterus transplantation: a systematic review

et al. 2020

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Summary The first uterus transplantation was performed in 2000. As key milestones are reached (long‐lasting graft survival in 2011, and first birth from a transplanted womb in 2014), the ethical debate around uterus transplant evolves. We performed a systematic review of articles on uterus transplantation. Ethical themes were extracted and categorized according to four bioethical principles. Papers were divided into time periods separated by key events in uterus transplant history: Phase I (first technical achievement, 2002–2011), Phase II (clinical achievement, 2012–2014), and Phase III (after the first childbirth, 2015–2018). Eighty‐one articles were included. The majority of ethics papers were published in Phase III (65%, P < 0.0001), that is after the first birth. Eighty percent of papers discussed nonmaleficence making it the most discussed principle. The first birth acted as a pivotal point: nonmaleficence was discussed by a lower proportion of articles (P = 0.0073), as was beneficence (P = 0.0309). However, discussion of justice increased to become the most discussed principle of the time period (P = 0.0085). The ethical debate surrounding uterus transplantation has evolved around landmark events that signify scientific progress. As safety and efficacy become evident, the focus of ethical debate shifts from clinical equipoise to socioeconomic challenges and equitable access to uterus transplantation.

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Section: Discussionmentioning

confidence: 99%

The changing paradigm of ethics in uterus transplantation: a systematic review

et al. 2020

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“…Of the forty-one partial and full facial CTA procedures reported to date, twenty-five have been performed in Europe [11]. Cost analyses comparing facial CTA to conventional reconstruction in the EU have not been reported yet.…”

Section: Cost Efficacy Of Facial Cta In the Eumentioning

confidence: 99%

A European perspective of the cost effectiveness of facial composite tissue allotransplantation

et al. 2019

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Background Facial composite tissue allotransplantation (CTA) may be considered in cases of severe facial injury. To date, no reports have analysed the cost of potential facial CTA in the UK. The aims of this study were to establish (1) the cost implications without facial CTA, necessitating multiple reconstructive procedures in cases with severe facial deformities, and (2) if facial CTA would be cost-effective in the UK given recent European and North American published cost analyses. Methods Hospital episodes' data from two potential candidates for facial CTA were used to calculate cost of treatment. In these cases, severe facial trauma was managed by multiple disciplinary teams performing numerous conventional reconstructive procedures. One case served as an indicator of the cost of primary reconstruction during the immediate post-traumatic episode, from admission until first discharge. The other served as an indicator of the accumulative cost of care following primary reconstruction from first discharge to six years later. Costs incurred served as a guide for the cost of standard reconstruction in the UK. These were compared with the costs of similar reconstructive procedures performed in the USA. This was used with data reporting the cost of facial CTA in the USA and France to predict the cost of facial CTA in the UK. Results Analysis revealed a cost benefit for facial CTA in a UK context that would become apparent from the third year posttransplant onwards. Conclusion Facial CTA may therefore be a more cost-effective long-term reconstructive option for patients with severe facial defects. Level of evidence: Level V, risk/prognostic study. declare that they have no conflict of interest.Ethical approval For this retrospective evaluation of cost, ethical approval is not required. However, all procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Informed consent For this type of study, formal consent is not required.Eur J Plast Surg (2020) 43:219-224 223Open Access This article is distributed under the terms of the Creative Comm ons Attribution 4.0 International License (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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“…[1] In today's esthetic driven society where smile and facial attractiveness represents one's happiness, mental state, and success, it is very difficult to attain normal and socially acceptable facial architecture after gross disfigurement. [2] Face transplant is a revolutionary procedure by which we can achieve so successfully.…”

Section: Introductionmentioning

confidence: 99%

Face transplant: A revolutionary approach and role of dentist

Nandkeoliar¹,

Deb²

2018

JCRI

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Face transplant forms a part of vascularized composite tissue allotransplantation (transfer of organs or tissue from one individual to another), which is the basis of modern microsurgery and reconstructive plastic surgery. A face transplant is a medical procedure to replace all or part of a person's face using tissue from a cadaver. Face transplantation can include skin from the face, neck and/or scalp, lips and tongue, muscles used for facial movement and expression, and nerves to animate as well as to provide sensation. Supportive bony structures can also be included. Oral surgeons play a major role in alignment of teeth, reconstruction of midface, maxilla, mandible including teeth, and tongue. It gives better esthetics and functional results including increase in the opening of mouth, chewing, and breathing. The new computer-assisted planning and execution system aims to make it less likely to misalign the new set of bones, jaws, and prevent other reconstructive abnormalities. In spite of risks and rejection, face transplant gives a better appearance, i.e., gives a new life to the patient and improves his social status and lifestyle.

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A review of the world’s published face transplant cases: ethical perspectives

Cited by 24 publications

References 54 publications

The changing paradigm of ethics in uterus transplantation: a systematic review

The changing paradigm of ethics in uterus transplantation: a systematic review

A European perspective of the cost effectiveness of facial composite tissue allotransplantation

Face transplant: A revolutionary approach and role of dentist

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