Infections Following Facial Composite Tissue Allotransplantation—Single Center Experience and Review of the Literature

Abstract

Nine publications described infectious complications in another 9 FCTA recipients. Early posttransplant infections were similar to those observed in our cohort and included pulmonary, surgical-site and catheterassociated infections. CMV was the most frequently described opportunist.In conclusion, infections following FCTA were related to anatomical, technical and donor/recipient factors. CMV disease occurred in D+/R− recipients after prophylaxis, but was not associated with rejection.

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

“…In this context, primary infection occurs when a CMV-seropositive donor transmits the latent virus through organ donation to a susceptible CMV-seronegative transplant recipient (herein referred to as CMV Dϩ/RϪ). The CMV Dϩ/RϪ mismatch category occurs in an estimated 20 to 25% of all SOT recipients (3) and is the single most important risk factor for the development of CMV disease in SOT recipients (3,(29)(30)(31)(32)(33)(34)(35). Much less commonly, primary CMV infection may be acquired from exposure to infected individuals in the community (i.e., saliva and other body fluids) or through transfusion of blood from CMV-infected donors (3,29).…”

“…Because CMV-seronegative SOT recipients lack preexisting CMV-specific humoral and cell-mediated immunity, their ability to suppress viral reactivation (in the infected allograft) is nonexistent, thereby allowing for very rapid CMV replication dynamics. The growth rate has been calculated at 1.82 units/day (95% confidence interval [CI], 1.44 to 2.56 units/day) (36), which is commensurate to a doubling time of Ͻ2 days (Table 1) (3,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). Clinically, this translates to a higher incidence and greater severity of CMV disease, characterized by high viral loads, among CMV Dϩ/RϪ SOT recipients (3,5,36,(41)(42)(43)(44)(45).…”

Significant Infections After Hand Transplantation in a Polish Population

“…Depending on the type and localization of allograft (face versus hand), various bacterial infection rates were observed. In case of face transplantation, the donor-derived flora colonizing oral and respiratory mucosa may be the cause of post-transplantation infection [4,5].…”

“…infections were noted, mostly with surgical site infection, bacteremia, or pneumonia. The common complication of antibacterial treatment was Clostridium difficileÀassociated diarrhea [5].…”

Vascularized Composite Allotransplant in the Realm of Regenerative Plastic Surgery

“…Other complications were reported in 7 patients, including severe intraoperative bleeding (requiring transfusion of 66 U of packed red blood cells), acute respiratory distress syndrome, renal insufficiency, and jugular thrombosis. [49][50][51] Opportunistic infections were common in the Boston experience, 51 with cytomegalovirus being the most frequent organism, but were not associated with rejection.…”