title: Facial transplantation: a concise update.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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 9 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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain. pinfante@us.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Infante-Cossio
authors.forename: Fernando
authors.initials: F
authors.lastname: Barrera-Pulido
authors.forename: Tomas
authors.initials: T
authors.lastname: Gomez-Cia
authors.forename: Domingo
authors.initials: D
authors.lastname: Sicilia-Castro
authors.forename: Alberto
authors.initials: A
authors.lastname: Garcia-Perla-Garcia
authors.forename: Purificacion
authors.initials: P
authors.lastname: Gacto-Sanchez
authors.forename: Jose-Maria
authors.initials: JM
authors.lastname: Hernandez-Guisado
authors.forename: Araceli
authors.initials: A
authors.lastname: Lagares-Borrego
authors.forename: Rocio
authors.initials: R
authors.lastname: Narros-Gimenez
authors.forename: Juan-David
authors.initials: JD
authors.lastname: Gonzalez-Padilla
mesh_terms: D054445:Facial Transplantation; D006801:Humans; D016896:Treatment Outcome