title: Outcomes 18 months after the first human partial face transplantation.
abstract: BACKGROUND
  We performed the first human partial face allograft on November 27, 2005. Here we report outcomes up to 18 months after transplantation.
  
  
  METHODS
  The postsurgical induction immunosuppression protocol included thymoglobulins combined with tacrolimus, mycophenolate mofetil, and prednisone. Donor hematopoietic stem cells were infused on postoperative days 4 and 11. Sequential biopsy specimens were taken from a sentinel skin graft, the facial skin, and the oral mucosa. Functional progress was assessed by tests of sensory and motor function performed monthly. Psychological support was provided before and after transplantation.
  
  
  RESULTS
  Sensitivity to light touch, as assessed with the use of static monofilaments, and sensitivity to heat and cold had returned to normal at 6 months after transplantation. Motor recovery was slower, and labial contact allowing complete mouth closure was achieved at 10 months. Psychological acceptance of the graft progressed as function improved. Rejection episodes occurred on days 18 and 214 after transplantation and were reversed. A decrease in inulin clearance led to a change in immunosuppressive regimen from tacrolimus to sirolimus at 14 months. Extracorporeal photochemotherapy was introduced at 10 months to prevent recurrence of rejection. There have been no subsequent rejection episodes. At 18 months, the patient is satisfied with the aesthetic result.
  
  
  CONCLUSIONS
  In this patient who underwent the first partial face transplantation, the functional and aesthetic results 18 months after transplantation are satisfactory.
authors: Department of Transplantology, Hôpital Edouard Herriot, Université Lyon 1, Centaure Network, Lyon, France. jean-michel.dubernard@chu-lyon.fr
authors: Jean-Michel
authors: JM
authors: Dubernard
authors: Benoit
authors: B
authors: Lengelé
authors: Emmanuel
authors: E
authors: Morelon
authors: Sylvie
authors: S
authors: Testelin
authors: Lionel
authors: L
authors: Badet
authors: Christophe
authors: C
authors: Moure
authors: Jean-Luc
authors: JL
authors: Beziat
authors: Stéphanie
authors: S
authors: Dakpé
authors: Jean
authors: J
authors: Kanitakis
authors: Cédric
authors: C
authors: D'Hauthuille
authors: Assia
authors: A
authors: El Jaafari
authors: Palmina
authors: P
authors: Petruzzo
authors: Nicole
authors: N
authors: Lefrancois
authors: Farid
authors: F
authors: Taha
authors: Angela
authors: A
authors: Sirigu
authors: Giovanni
authors: G
authors: Di Marco
authors: Esther
authors: E
authors: Carmi
authors: Danielle
authors: D
authors: Bachmann
authors: Sophie
authors: S
authors: Cremades
authors: Pascal
authors: P
authors: Giraux
authors: Gabriel
authors: G
authors: Burloux
authors: Olivier
authors: O
authors: Hequet
authors: Nathalie
authors: N
authors: Parquet
authors: Camille
authors: C
authors: Francès
authors: Mauricette
authors: M
authors: Michallet
authors: Xavier
authors: X
authors: Martin
authors: Bernard
authors: B
authors: Devauchelle
mesh_terms: D000328:Adult; D004954:Esthetics; D005145:Face / Q000502:physiology*; D005151:Facial Injuries / Q000601:surgery*; D054445:Facial Transplantation / Q000009:adverse effects / Q000379:methods / Q000473:pathology / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010778:Photochemotherapy; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents