title: Clinicopathologic monitoring of the skin and oral mucosa of the first human face allograft: Report on the first eight months.
abstract: BACKGROUND
  The first human face allograft was performed in France on November 27, 2005. We report herein the clinicopathologic findings from the skin and oral mucosa of this allograft during the first eight months.
  
  
  METHODS
  Sequential biopsies were taken from the facial skin (n = 3), oral mucosa (n = 20), and sentinel skin graft (n = 11) from day 3 to day 220 postgraft and examined (immuno)histologically, using a pathological score previously proposed for evaluation of rejection in composite tissue (hand) transplantation.
  
  
  RESULTS
  The patient developed clinically rejection episodes at day 20 and during the eighth month postgraft, manifesting with redness and edema of the facial skin, oral mucosa, and sentinel graft skin. Pathologically, changes suggestive of rejection grades 0, I, II, and III were seen in 1, 1, 1, and 0 biopsies of facial skin, 7, 2, 1, and 1 biopsies of sentinel skin graft and 3, 5, 8, and 4 biopsies of oral mucosa, respectively. Pathological changes were generally more severe in the oral mucosa than in facial and sentinel graft skin (mean scores 1.85, 0.64, and 1, respectively).
  
  
  CONCLUSIONS
  As it happens with other composite tissue allografts, close clinicopathologic monitoring of the skin (and oral mucosa) seems to be the most reliable way to detect rejection in the setting of human facial tissue allotransplantation. Apart from these rejection episodes, the skin and mucosa maintained a normal microscopic structure, paralleling functional recovery.
authors.affiliation: Department of Dermatology, Ed. Herriot Hospital, Lyon, France. kanitakis@lyon.inserm.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Kanitakis
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.forename: Palmina
authors.initials: P
authors.lastname: Petruzzo
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Béziat
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Morelon
authors.forename: Nicole
authors.initials: N
authors.lastname: Lefrançois
authors.forename: Camille
authors.initials: C
authors.lastname: Françès
authors.forename: Alain
authors.initials: A
authors.lastname: Claudy
authors.forename: Xavier
authors.initials: X
authors.lastname: Martin
authors.forename: Benoit
authors.initials: B
authors.lastname: Lengelé
authors.forename: Sylvie
authors.initials: S
authors.lastname: Testelin
authors.forename: Bernard
authors.initials: B
authors.lastname: Devauchelle
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Dubernard
mesh_terms: D000328:Adult; D001733:Bites and Stings / Q000473:pathology* / Q000601:surgery; D005145:Face / Q000473:pathology*; D005151:Facial Injuries / Q000473:pathology* / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000473:pathology*; D006085:Graft Survival; D006801:Humans; D008991:Monitoring, Physiologic; D009061:Mouth Mucosa / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D016038:Skin Transplantation; D014019:Tissue Donors; D014184:Transplantation, Homologous