Pediatric Vascularized Composite Allotransplantation

Doumit, Gaby; Gharb, Bahar Bassiri; Rampazzo, Antonio; Papay, Francis; Siemionow, Maria

doi:10.1097/sap.0000000000000300

Cited by 16 publications

(9 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At this time, considering the unknowns of PHT (eg, optimal selection criteria, outcomes), it is difficult to accurately perform this risk-benefit analysis. 25 Although nearly half of both US and AU therapists (47.3% and 46.2%, respectively) thought emergency PHT should be permitted due to the complexity of the VCA assessment process, it seems difficult to perform a thorough patient and donor assessment in a short time frame. Additionally, in a timelimited setting, the ethically advantageous ''cooling-off'' period for the potential recipient would be eliminated and this could compromise the assent process.…”

Section: Discussionmentioning

confidence: 99%

“…From an ethical standpoint, while PHT can potentially restore hand and digit sensation, the cost involves the burdens of immunosuppression among other risks and unknowns. 25 This said, a trial of prosthetics seems appropriate as a stepping stone to assessing both function and personal satisfaction amid restorative options. To facilitate this, insurance companies and health services should provide benefits for prosthetics that are optimized for fit, function, and cosmetics.…”

Section: Discussionmentioning

confidence: 99%

“…At this time, considering the unknowns of PHT (eg, optimal selection criteria, outcomes), it is difficult to accurately perform this risk–benefit analysis. 25…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Perspectives of US and Australian Hand Therapists About Pediatric Hand Transplantation

Mukesh

Bramstedt

2016

Prog Transpl

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perspectives of US and Australian Hand Therapists About Pediatric Hand Transplantation

Mukesh

Bramstedt

2016

Prog Transpl

View full text Add to dashboard Cite

show abstract

“…An interesting point of view on this matter is offered by the first bilateral hand transplantation conducted on 8-year old Zion at the Children's Hospital of Philadelphia by the team led by Scott Levin. 48,49 Ethical dilemma, such as the need for life-long immunosuppression and the related risk to develop cancer if undergoing VCAs in childhood, has restrained surgeons and patients from exploring this area.…”

Section: Challenges Facing the Futurementioning

confidence: 99%

Reflections on a Decade of Face Transplantation

2017

View full text Add to dashboard Cite

On November 27, 2005, Isabelle Dinoire underwent the world's first partial face transplant in Amiens (France) after a dog attack had left her face severely disfigured. The abrupt surgical leap found the medical community and society unprepared to deal with the scientific, ethical, and societal implications of a surgical procedure that was striving to transition from sci-fi novels to science. Today, 10 years and over 35 transplants later, public opinion has become accustomed to the concept of "face restoration" through transplantation. However, face transplantation is far from being a safe "routine" surgery and the science behind it is still mostly unknown. Patients and multidisciplinary teams of physicians confront daily medical challenges, life-threatening risks, and personal struggle that only in part come to light. Could (or should) this be the laborious, uncertain, and high-risk trajectory of disruptive medical innovation? Over the last decade, some medical discoveries and surgical advancements in the field have been closely accompanied by partial regulatory frameworks, intense ethical discussions, and meaningful changes in social beliefs across cultures and continents. Yet, a very long way is to come and the questions we still have today greatly outweigh the answers we can offer. Here, we take the chance of the 10-year anniversary of face transplantation to reflect on the path traveled and to look forward to the challenges lying ahead.

show abstract

“…The youngest FAT and hand transplant recipients reported were, respectively, 19 and 8 years old . Solid arguments against FAT in children include the lifelong risks of immunosuppression and the disputed informed consent .…”

Section: Ethical Dilemmasmentioning

confidence: 99%

Face transplantation-current status and future developments

et al. 2018

View full text Add to dashboard Cite

More than thirty-five facial allograft transplantations (FAT) have been reported worldwide since the pioneering case performed in France in the year 2005. FAT has received tremendous interest by the medical field and the general public while gaining strong support from multiple disciplines as a solution for reconstructing complex facial defects not amenable/responsive to conventional methods. FAT has expanded the frontiers of reconstructive microsurgery, immunology and transplantation, and established its place in the cross section of multiple disciplines. The procedure introduces complex scientific, ethical, and societal issues. Patients and physicians are called to deal with a variety of-sometimes everlasting-challenges, such as immunosuppression management and psychosocial hurdles. This review reflects on the surgical and scientific advancements in FAT and milestones reached in the last 12 years. It aims to encourage active discussion regarding the current practices and techniques used in FAT and suggest future directions that may allow transitioning into the next phase of FAT, which we describe as safe, reliable, and accessible standard operation for selected patients.

show abstract

Pediatric Vascularized Composite Allotransplantation

Abstract: Considering the non-life-threatening nature of the conditions that lead to eligibility for VCA, it is suggested that it is premature to extend the indications of VCA to include pediatric patients under the currently available immunosuppressive protocols.

Cited by 16 publications

References 81 publications

Perspectives of US and Australian Hand Therapists About Pediatric Hand Transplantation

Perspectives of US and Australian Hand Therapists About Pediatric Hand Transplantation

Reflections on a Decade of Face Transplantation

Face transplantation-current status and future developments

Contact Info

Product

Resources

About