Face Transplantation Program in France

Rüegg, Eva Meia; Hivelin, Mikaël; Hémery, François; MacIver, Colin; Benjoar, Marc-David; Meningaud, Jean Paul; Lantieri, Laurent

doi:10.1097/tp.0b013e31824e75fa

Cited by 35 publications

(15 citation statements)

References 15 publications

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“…One patient died 27 months after surgery because of a lack of compliance considering the immunosuppressive therapy [10]. The second case of death has occurred in the third French recipient due to prolonged anoxic cardiac arrest following multidrug-resistant infections and consequent graft necrosis [11]. The third patient deceased in July 2013 after suffering from recurrent cancer [45].…”

Section: Resultsmentioning

confidence: 99%

“…So far, no case of graft loss, hyperacute or chronic rejection, or graft-versus-host disease has been reported. With exception of one case, all patients who underwent facial transplantation surgery returned to normal life [8, 11]. …”

Section: Resultsmentioning

confidence: 99%

“…Only case reports, original articles, and review articles were taken into consideration. According to our inclusion and exclusion criteria, finally 36 articles were included in the compilation of our review [8, 9, 11–44]. Additionally information was gathered from scientific meeting presentations and from media reports, especially those concerning the latest cases with a follow-up period of less than one year.…”

Section: Methodsmentioning

confidence: 99%

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Face Transplantation: On the Verge of Becoming Clinical Routine?

Smeets

Rendenbach

Birkelbach

et al. 2014

BioMed Research International

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Introduction. Face transplantation (FT) is an innovative achievement of modern reconstructive surgery and is on the verge of becoming a common surgical opportunity. This review article was compiled to provide an update on this surgical field, especially regarding clinical outcomes, benefits, and complications implied. Methods. We performed an extensive research on all English-language Medline articles, case reports, and reviews published online until September 15, 2013. Used search terms were “face transplantation,” “face transplant,” “facial transplantation,” “facial transplant,” “face allograft,” and “facial allograft.” Results. To date 27 FTs have been performed worldwide. 19 of these cases have been published in the Medline database. Long-term follow-up reports of FT cases are rare. Three deaths associated with the procedure have occurred to date. The clinical outcomes of FT are satisfying. Reinnervation of sensation has been faster than motor recovery. Extensive functional improvements have been observed. Due to strict immunosuppression protocols, no case of hyperacute or chronic rejection and no graft-versus-host disease have occurred to date. Conclusions. As studies on long-term outcomes are missing, particularly regarding immunosuppression-related complications, FT will stay experimental for the next years. Nevertheless, for a small group of patients, FT already is a feasible reconstructive option.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Face Transplantation: On the Verge of Becoming Clinical Routine?

Smeets

Rendenbach

Birkelbach

et al. 2014

BioMed Research International

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“…11 Management of patients with extensive neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation (Fig 3). 12 No respiratory failure, favoured by massive transfusion like transfusion-related acute lung injury was observed intraoperatively or immediately after operation. No signs of disseminated intravascular coagulation or fibrinolysis were observed.…”

Section: Discussionmentioning

confidence: 97%

Anaesthesia and intensive care management of face transplantation

Sedaghati-Nia

Gilton

Liger

et al. 2013

British Journal of Anaesthesia

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The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.

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“…The different cost factors in euros are represented by different colors. FT, face transplantation (From Ruegg et al J Transplantation 2012;93:1166-72, with permission from Lippincott Williams [9]).…”

Section: Figmentioning

confidence: 99%

Facial Transplantation Surgery

Eun

2014

Arch Plast Surg

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It is well known that patients with severe facial injuries accompanied by facial disfiguration are vulnerable to a poor quality of life. With the help of facial transplantation, it has become possible to achieve an optimal anatomical reconstruction. As compared to conventional methods, it can provide more desirable functional, aesthetic, and psychosocial outcomes. Face transplantation surgeons need to consider many problems associated with the criteria for selecting patients, techniques for harvesting the donor tissue, prediction of the expected functional outcomes, limitations in obtaining written informed consent for conducting the procedure, evaluation of the post-transplant immunological response and postoperative immunosuppressant requirements, psychological and social outcomes for the patients, and other concerns about funding and ethical issues.

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Face Transplantation Program in France

Cited by 35 publications

References 15 publications

Face Transplantation: On the Verge of Becoming Clinical Routine?

Face Transplantation: On the Verge of Becoming Clinical Routine?

Anaesthesia and intensive care management of face transplantation

Facial Transplantation Surgery

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