A Second Chance at Life

Lellouch, Alexandre G.; Lantieri, Laurent

doi:10.1017/s0963180119000380

Cited by 6 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…a Time to perform inset of the allograft and vascular anastomoses. Skin biopsies performed after allotransplantation did not show significant rejection episodes, all samples were classified 0 on the Banff scale by the two blinded pathologists besides the SCS group at the euthanasia time point (Banff grade 1 [1,2]). Detailed skin histology is displayed in Supplementary Table S1.…”

Section: Macroscopic Observations and Histological Findings At End Of...mentioning

confidence: 99%

“…), congenital diseases, and neoplasia are responsible for severe disfigurements and amputation of functional aesthetic units in patients of all ages. For cases where autologous reconstructive options have been exhausted, vascularized composite allograft (VCA) transplantation offers significant quality of life improvements [ 1 ]. Although immense progress has been made in VCA procurement techniques, graft adjustments to the recipient, and post-operative care to achieve optimal results [ 2 , 3 ], a more effective and longer graft preservation method is needed to make VCA transplantation a routine reconstructive procedure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Machine Perfusion Enables 24-h Preservation of Vascularized Composite Allografts in a Swine Model of Allotransplantation

Goutard,

Tawa,

Berkane

et al. 2024

Transpl Int

Self Cite

View full text Add to dashboard Cite

The current gold standard for preserving vascularized composite allografts (VCA) is 4°C static cold storage (SCS), albeit muscle vulnerability to ischemia can be described as early as after 2 h of SCS. Alternatively, machine perfusion (MP) is growing in the world of organ preservation. Herein, we investigated the outcomes of oxygenated acellular subnormothermic machine perfusion (SNMP) for 24-h VCA preservation before allotransplantation in a swine model. Six partial hindlimbs were procured on adult pigs and preserved ex vivo for 24 h with either SNMP (n = 3) or SCS (n = 3) before heterotopic allotransplantation. Recipient animals received immunosuppression and were followed up for 14 days. Clinical monitoring was carried out twice daily, and graft biopsies and blood samples were regularly collected. Two blinded pathologists assessed skin and muscle samples. Overall survival was higher in the SNMP group. Early euthanasia of 2 animals in the SCS group was linked to significant graft degeneration. Analyses of the grafts showed massive muscle degeneration in the SCS group and a normal aspect in the SNMP group 2 weeks after allotransplantation. Therefore, this 24-h SNMP protocol using a modified Steen solution generated better clinical and histological outcomes in allotransplantation when compared to time-matched SCS.

show abstract

Section: Macroscopic Observations and Histological Findings At End Of...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Machine Perfusion Enables 24-h Preservation of Vascularized Composite Allografts in a Swine Model of Allotransplantation

Goutard,

Tawa,

Berkane

et al. 2024

Transpl Int

Self Cite

View full text Add to dashboard Cite

show abstract

“…2 However, despite these improvements, the number of complications (metabolic, infectious, and neoplastic) resulting from long-term immunosuppression 3 raises many ethical issues 4 and remains the source of much controversy. 5,6 Immunologically, VCA patients must comply with life-long maintenance immunosuppression, typically using a standard triple drug regimen (i.e. : a calcineurin inhibitor, mycophenolate mofetil (MMF), and steroids).…”

Section: Introductionmentioning

confidence: 99%

First human facial retransplantation: 30-month follow-up

et al. 2020

View full text Add to dashboard Cite

“…2 Follow-up reports indicate a true benefit in terms of quality of life for patients who get a second face. 3 We report here an uncommon surgical situation in a face transplant patient-a 57-year-old man who presented with a bifocal mandibular fracture and a nasal bone fracture due to a domestic accident 8 years after his partial face transplantation. Fifteen years after the first face transplant ever performed, it remains crucial to report the outcomes in the mid-and long-term follow-up for each patient.…”

mentioning

confidence: 99%

Facial Trauma 8 years after a Face Transplantation

Goutard

Lellouch

Dussol

et al. 2021

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

Summary Over the past 20 years, vascularized composite allografts (VCAs) have emerged as a realistic option in reconstructive surgery. Long-term follow-up reports indicate that face transplant patients have gained in quality of life and social integration. However, they require close monitoring of their immunosuppressive therapy because they are at high-risk for acute rejection episodes, leading eventually to chronic rejection and allograft loss. Reported acute rejection episodes in VCA recipients occur due to low immunosuppressive therapy (mainly due to lack of patient compliance or decreased doses of immunosuppressants to counter side-effects). Repeated mechanical traumas have recently been shown to trigger acute rejection episodes, especially in hand transplant patients. This article reports our experience of a 10-year follow-up of a 57-year-old face transplant patient and the management of his accidental facial trauma. To our knowledge, our patient is the first to undergo a major trauma on his VCA endangering his graft function and vitality. This report discusses the management of an acute surgical situation in those particular patients, and the challenges that arise to avoid acute rejection of the allograft. Ten years into his face transplant and at 18 months follow-up after his facial trauma, our patient shows great aesthetic and functional outcomes and remains rejection-free; a very encouraging result for all VCA candidates.

show abstract

A Second Chance at Life

Cited by 6 publications

References 24 publications

Machine Perfusion Enables 24-h Preservation of Vascularized Composite Allografts in a Swine Model of Allotransplantation

Machine Perfusion Enables 24-h Preservation of Vascularized Composite Allografts in a Swine Model of Allotransplantation

First human facial retransplantation: 30-month follow-up

Facial Trauma 8 years after a Face Transplantation

Contact Info

Product

Resources

About