Second Human Facial Allotransplantation to Restore a Severe Defect following Radical Resection of Bilateral Massive Plexiform Neurofibromas

Gómez-Cía, Tomás; Sicilia-Castro, Domingo; Infante-Cossio, Pedro; Barrera-Pulido, Fernando; Gacto-Sánchez, Purificación; Lagares-Borrego, Araceli; Narros-Gimenez, Rocio; García-Perla, Alberto; Hernández-Guisado, José-María; Gonzalez-Padilla, Juan-David

doi:10.1097/prs.0b013e318200b00b

Cited by 41 publications

(28 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lantieri et al (11) described transfusion requirements of 10 or more units of packed red blood cells in each of their first four patients. There was also a severe blood loss in our patient case (26), as 24 packed red blood cells units were transfused resulting in a post-transplant dilutional coagulopathy. It is interesting to note that our patient developed rhabdomyolysis after transplantation, which was attributed to both massive blood loss and to an intra-operative immobilization long period (18).…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Facial transplantation: A concise update

Infante-Cossio

Barrera-Pulido²,

Gómez-Cía³

et al. 2013

Med Oral

View full text Add to dashboard Cite

Objectives: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. Study design: MEDLINE search of articles published on “face transplantation” until March 2012. Results: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 8 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. Conclusions: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients. Key words:Face transplantation, composite tissue transplantation, face allograft, facial reconstruction, outcomes and complications of face transplantation.

show abstract

Section: Discussionmentioning

confidence: 67%

“…In these cases, subsequent osteosynthesis must be performed and dental occlusion ensured. The chin segment was also transplanted as a mono-block (26). Some teams found it difficult to achieve an adequate bone fixation due to anatomical differences between donor and recipient (6).…”

Section: Discussionmentioning

confidence: 99%

Facial transplantation: A concise update

Infante-Cossio

Barrera-Pulido²,

Gómez-Cía³

et al. 2013

Med Oral

View full text Add to dashboard Cite

show abstract

“…Two patients suffered from neurofibromatosis and consequent paralysis of almost the entire face (30,33), whereas the extent of damaged functional structures in the remaining six patients varied significantly. Absence of depressor muscles (20,36), upper lip (22), orbicularis oris (26,35) or other oral muscles (32) as well as impaired labial competence (27,34,36) suggests an inability to smile or to grimace properly before FT. Posttransplant follow-up reports stated successful reinnervation of facial muscles, the earliest after 3 months (27,33) as well as absent reinnervation after 2 years due to failed nerve anastomosis (22).…”

Section: Facial Expressionmentioning

confidence: 99%

Functional Outcomes of Face Transplantation

Fischer

Kueckelhaus

Pauzenberger

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

In this study we provide a compilation of functional impairments before and improvements after face transplantation (FT) of five FT recipients of our institution and all FTs reported in current literature. Functional outcome included the ability to smell, breath, eat, speak, grimace and facial sensation. Before FT, all our patients revealed compromised ability to breath, eat, speak, grimace and experience facial sensation. The ability to smell was compromised in two of our five patients. Two patients were dependent on tracheostomy and one on gastrostomy tubes. After FT, all abilities were significantly improved and all patients were independent from artificial air airways and feeding tubes. Including data given in current literature about the other 24 FT recipients in the world, the abilities to smell, eat and feel were enhanced in 100% of cases, while the abilities of breathing, speaking and facial expressions were ameliorated in 93%, 71% and 76% of cases, respectively. All patients that required gastrostomy and 91% of patients depending on tracheostomy were decannulated after FT. Unfortunately, outcomes remain unreported in all other cases and therefore we are unable to comment on improvements.

show abstract

“…Since 2005 twenty-seven facial transplants were performed (Barret et al, 2011;Cavadas, Ibanez, & Thione, 2012;Devauchelle et al, 2006;Dubernard et al, 2007;Gomez-Cia et al, 2011;Guo et al, 2008;Lantieri et al, 2008Lantieri et al, , 2011Petruzzo et al, 2012;Pomahac, Nowinski, & Diaz-Siso, 2011, Pomahac et al, 2012Roche et al, 2014;Shanmugarajah, Hettiaratchy, & Butler, 2011;Shanmugarajah, Hettiaratchy, Clarke, & Butler, 2012;Siemionow, Gharb, & Rampazzo, 2013;Siemionow & Ozturk, 2011. In most cases the surgical, immunological and functional (i.e.…”

Section: Introductionmentioning

confidence: 98%