Partial Loss of Nasal Tissue in a Facial Vascularized Composite Allograft Patient

Kauke, Martin; Tchiloemba, Bianief; Haug, Valentin; Kollar, Branislav; Safi, Ali-Farid; Pomahač, Bohdan

doi:10.1097/gox.0000000000003038

Cited by 9 publications

(9 citation statements)

References 5 publications

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“…Our understanding of mucosal allograft rejection is limited to date; however, recent studies indicate that mucosa may be one of the primary targets of rejection in fVCA. 21-23…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus-related Complications and Management in Facial Vascularized Composite Allotransplantation: An International Multicenter Retrospective Cohort Study

et al. 2022

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Original Clinical Science-GeneralBackground. There is a paucity of data on the impact of cytomegalovirus (CMV) serostatus and CMV infection on outcomes in facial vascularized composite allotransplantation. Methods. This international, multicenter, retrospective cohort study presents data on CMV and basic transplant-related demographics, including pretransplant viral D/R serostatus, and duration of antiviral prophylaxis. CMV-related complications (viremia, disease), allograft-related complications (rejection episodes, loss), and mortality were analyzed. Results. We included 19 patients, 4 of whom received CMV high-risk transplants (D+/R−). CMV viremia was noted in 6 patients (all 4 D+/R− patients and 2 D−/R+), mostly within the first-year posttransplant, shortly after discontinuation of antiviral prophylaxis (median 2 mo). CMV disease occurred in 2 D+/R− patients. The high-risk group experienced relatively more rejection episodes per month follow-up. None of D+/R− patients suffered allograft loss due to rejection (longest follow-up: 121 mo). Conclusions. D+/R− patients were at increased risk of CMV-related complications. Although a higher number of rejections was noted in this group, none of the D+/R− patients lost their allograft or died because of CMV or rejection. Thus, CMV D+/R− face transplantation can likely be safely performed with prophylaxis, active surveillance, and prompt treatment.

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“…Our understanding of mucosal allograft rejection is limited to date; however, recent studies indicate that mucosa may be one of the primary targets of rejection in fVCA. 21-23…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus-related Complications and Management in Facial Vascularized Composite Allotransplantation: An International Multicenter Retrospective Cohort Study

et al. 2022

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“…5,12 Recent reports have highlighted the potential effect of repeated TCMR in the absence of GV. 13 Repeated rejection episodes of the alar base lead to gradual tissue disappearance. 13 In a 10-year-follow-up of a patient we identified no GV on the removed allograft despite repeated TCMRs.…”

Section: Discussionmentioning

confidence: 99%

“…Exemplarily, Morelon et al reported GV with C4d vascular deposits in a patient who developed de novo DSAs 7 years posttransplant and was thought to have an antibody‐mediated insult to the vessels 5,12 . Recent reports have highlighted the potential effect of repeated TCMR in the absence of GV 13 . Repeated rejection episodes of the alar base lead to gradual tissue disappearance 13 .…”

Section: Discussionmentioning

confidence: 99%

“…13 Repeated rejection episodes of the alar base lead to gradual tissue disappearance. 13 In a 10-year-follow-up of a patient we identified no GV on the removed allograft despite repeated TCMRs. The chronic skin changes such as papillary dermal sclerosis, epidermal thinning with loss of rete ridges, and progressive loss of color were presumed to be due to rejection.…”

Section: Discussionmentioning

confidence: 99%

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Full facial retransplantation in a female patient—Technical, immunologic, and clinical considerations

Kauke

Safi

Haug

et al. 2021

American Journal of Transplantation

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Facial vascularized composite allotransplantation (fVCA) has the ability to restore the facial appearance and function of severely injured patients. 1 A barrier preventing wider implementation of the procedure is allograft rejection, with chronic rejection resulting in necrosis and complete graft loss. Unlike complete rejection in handtransplantation which can be treated with amputation and a return

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“…One must consider invisible (e.g., immunologic, infectious) compatibility criteria to minimize the risk of acute (and chronic) allograft rejection and infection. 3–5 In addition, visible (physical appearance) compatibility criteria bear great relevance for facial vascularized composite allotransplant donor-recipient matching. 6 Some donor exclusion criteria such as sex, skin color, blood type, and body mass index are recipient specific.…”

mentioning

confidence: 99%

Donor and Recipient Matching in Facial Vascularized Composite Allotransplantation: A Closer Look at the Donor Pool

Kauke¹,

Haug

Obed³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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ace transplantation has become the standard of care for selected severely disfigured patients. 1 A successful facial vascularized composite allotransplant requires careful donorrecipient matching. 2 The process of identifying a suitable donor can be challenging and timeconsuming. One must consider invisible (e.g., immunologic, infectious) compatibility criteria to minimize the risk of acute (and chronic) allograft rejection and infection. [3][4][5] In addition, visible (physical appearance) compatibility criteria bear great relevance for facial vascularized composite allotransplant donor-recipient matching. 6 Some donor exclusion criteria such as sex, skin color,

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Partial Loss of Nasal Tissue in a Facial Vascularized Composite Allograft Patient

Cited by 9 publications

References 5 publications

Cytomegalovirus-related Complications and Management in Facial Vascularized Composite Allotransplantation: An International Multicenter Retrospective Cohort Study

Cytomegalovirus-related Complications and Management in Facial Vascularized Composite Allotransplantation: An International Multicenter Retrospective Cohort Study

Full facial retransplantation in a female patient—Technical, immunologic, and clinical considerations

Donor and Recipient Matching in Facial Vascularized Composite Allotransplantation: A Closer Look at the Donor Pool

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