OPTN Vascularized Composite Allograft Waiting List: Current Status and Trends in the United States

Wainright, J. L.; Wholley, Christopher; Cherikh, Wida S.; Musick, Jennifer M; Klassen, David K.

doi:10.1097/tp.0000000000002232

Cited by 21 publications

(18 citation statements)

References 16 publications

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“…These additional readings further describe hand transplant background [59] and outcomes, [59,60] immunosuppression needed for vascularized composite allotransplantation (VCA), [61,62] complications in VCA, [63] and transplant waiting lists [64].…”

Section: Genetic Engineering Limb Growth and Transplantation (Additional Reading)mentioning

confidence: 99%

Frontiers of Brachial Plexus Injury: Future Revolutions in the Field

Rosen¹,

Hong²,

Klaudt-Moreau³

et al. 2022

Brachial Plexus Injury - New Techniques and Ideas

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The field of brachial plexus surgery has undergone dramatic changes in the past 40 years. Most of these have been incremental in nature. We have seen increased use of nerve grafts and nerve transfers. We have seen the introduction of robotic limb replacements for the most severe flail limbs where surgical intervention has failed. In some cases, we have seen an increase in the use of computer simulation and virtual reality to train surgeons to plan and execute surgeries. More recently, we have seen the introduction of technologies derived from regenerative medicine research.

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Section: Genetic Engineering Limb Growth and Transplantation (Additional Reading)mentioning

confidence: 99%

Frontiers of Brachial Plexus Injury: Future Revolutions in the Field

Rosen¹,

Hong²,

Klaudt-Moreau³

et al. 2022

Brachial Plexus Injury - New Techniques and Ideas

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“…Despite 40% of brain-dead donors meeting initial screening criteria for VCA donation, wait times for FT may exceed 2 years, reflecting the potential to expand the VCA donor pool. 19 Furthermore, authorization for VCA donation is often difficult to navigate with families, although educational intervention has been proved to significantly increase willingness to donate. 20 …”

Section: Pre-transplantation Considerationsmentioning

confidence: 99%

The 2020 Facial Transplantation Update: A 15-Year Compendium

Diep

Berman

Alfonso

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary Over the past 15 years, landmark achievements have established facial transplantation (FT) as a feasible reconstructive option for otherwise irreparable craniofacial defects. However, as the field matures and long-term outcomes begin to emerge, FT teams around the world are now facing new challenges. Data for this review were identified by searches of the PubMed/MEDLINE database from inception through August 2020. All English-language articles pertaining to FT were included. Significant advances in candidate selection, technology, operative technique, posttransplant care, and immunosuppressive management have contributed to the tremendous expansion of the field, culminating in the execution in the past 3 years of 2 facial re-transplantations, and most recently the world’s first successful combined face and double hand transplant in August 2020. Despite these achievements, the allograft donor pool remains limited, with long wait times, requiring surgical experimentation with cross-sex FT. Immunosuppressive management has improved, but significant adverse events continue to be reported. Most recently, the COVID-19 pandemic has placed an unprecedented strain on the healthcare system, with various implications for the practice of reconstructive transplantation. In this article, we provide the most comprehensive and up-to-date FT review, highlighting fundamental lessons learned and recent advancements, while looking toward the challenges ahead. Over the past 15 years, extensive multidisciplinary efforts have been instrumental to the establishment of FT as a feasible reconstructive option. As novel challenges are beginning to emerge, continued collaborative and multispecialty research efforts are needed to further this field.

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“… 1 – 5 The shortage of donor facial allografts has led to prolonged transplant wait times. 6 This is due to the need for rigorous immunologic, anatomic, and color-specific donor–recipient matching, as well as cultural and societal beliefs, and educational gaps leading to reluctance to donate facial tissue. The focus in FT research is shifting in addressing the composition of the donor pool and emphasizing selection criteria as a priority.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Perception of Cross-sex Face Transplantation to Expand the Donor Pool

Sosin

Robinson

Diep

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: A major challenge in face transplantation (FT) is the limited donor allograft pool. This study aimed to investigate the feasibility of cross-sex FT (CSFT) for donor pool expansion by: (1) comparing craniomaxillofacial metrics following CSFT versus same-sex FT (SSFT); and (2) evaluating the public and medical professionals’ perception of CSFT. Methods: Seven cadaveric FTs were performed, resulting in both CSFT and SSFT. Precision of bony and soft tissue inset was evaluated by comparing pre- versus post-operative cephalometric and anthropometric measurements. Fidelity of the FT compared to the virtual plan was assessed by imaging overlay techniques. Surveys were administered to medical professionals, medical students, and general population to evaluate opinions regarding CSFT. Results: Five CSFTs and 2 SSFTs were performed. Comparison of recipients versus post-transplant outcomes showed that only the bigonial and medial intercanthal distances were statistically different between CSFT and SSFT (P = 0.012 and P = 0.010, respectively). Of the 213 survey participants, more were willing to donate for and undergo SSFT, compared with CSFT (donate: 59.6% versus 53.0%, P = 0.001; receive: 79.5% versus 52.3%, P < 0.001). If supported by research, willingness to receive a CSFT significantly increased to 65.6% (P < 0.001). On non-blinded and blinded assessments, 62.9% and 79% of responses rated the CSFT superior or equal to SSFT, respectively. Conclusions: Our study demonstrates similar anthropometric and cephalometric outcomes for CSFT and SSFT. Participants were more reticent to undergo CSFT, with increased willingness if supported by research. CSFT may represent a viable option for expansion of the donor pool in future patients prepared to undergo transplantation.

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OPTN Vascularized Composite Allograft Waiting List: Current Status and Trends in the United States

Cited by 21 publications

References 16 publications

Frontiers of Brachial Plexus Injury: Future Revolutions in the Field

Frontiers of Brachial Plexus Injury: Future Revolutions in the Field

The 2020 Facial Transplantation Update: A 15-Year Compendium

Feasibility and Perception of Cross-sex Face Transplantation to Expand the Donor Pool

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