title: Perioperative management of face transplantation: a survey.
abstract: BACKGROUND
  Since the first facial allograft transplantation was reported in France in 2005, 18 cases have been performed in 4 countries and the rate is increasing.
  
  
  METHODS
  We have devised a survey to assess anesthesia-related management and rationale of facial allograft transplantation. It was sent to the lead anesthesiologists of the first 14 face transplants performed worldwide.
  
  
  RESULTS
  Responses were received corresponding to 13 face transplants. The median duration of surgery and anesthesia was 19 hours (95% confidence interval 15-23 hours). The surgical preparation and dissection of multiple small anatomical structures of the recipient was time-consuming for 11 cases. Blood loss was considerable. All patients received packed red blood cells (median 20 U, 95% confidence interval 5-28 U). A median of 13 L of crystalloid was administered (95% confidence interval 10-18 L).
  
  
  CONCLUSIONS
  During facial allograft transplantation, the anesthesiologist must be prepared for a long anesthetic with rapid blood loss after reperfusion of the graft.
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. tedrich@partners.org
authors.forename: Thomas
authors.initials: T
authors.lastname: Edrich
authors.forename: Jacek B
authors.initials: JB
authors.lastname: Cywinski
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Colomina
authors.forename: Ignacio
authors.initials: I
authors.lastname: Jiménez López
authors.forename: Lize
authors.initials: L
authors.lastname: Xiong
authors.forename: Amir
authors.initials: A
authors.lastname: Sedaghati
authors.forename: Bohdan
authors.initials: B
authors.lastname: Pomahac
authors.forename: Alain
authors.initials: A
authors.lastname: Gilton
mesh_terms: D058109:Airway Management; D000758:Anesthesia; D016063:Blood Loss, Surgical / Q000517:prevention & control; D054445:Facial Transplantation; D006801:Humans; D019990:Perioperative Care