title: Allogenic submandibular gland transplantation following hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Autologous submandibular gland transfer for treatment of progressive dry eye symptoms requires a functionally intact submandibular gland. In cases of total function loss of both lacrimal and submandibular glands this procedure has to be modified. Here we report on the first two cases of the allogenic transplantation of a submandibular gland to treat patients suffering from complete functional loss of both glands due to graft-versus-host disease (GvHD) following stem cell transplantation.
  
  
  METHODS
  We carried out allogenic transplantation of the submandibular gland of the matched former stem cell donor to the temporal fossa of the stem cell recipient suffering from GvHD-induced dry eye. The treatment was carried out in two male patients who showed complete donor chimerism to the stem cell donors, so that no immunosuppressive therapy was applied.
  
  
  RESULTS
  Postoperative clinical assessment of the patients revealed primary success of the procedure. The ocular surface showed improvement of lubrication and reduction of inflammatory signs. In the long-term follow-up sialoscintigraphy revealed lower tracer activity than expected and secretion of saliva-tears decreased.
  
  
  CONCLUSIONS
  Even though the so-called total donor chimerism was assessed allogenic transplantation of the submandibular gland following GvHD-induced dry eye showed signs of organ rejection and therefore initial immunosuppressive therapy after allogenic transplantation has to be considered.
authors: Department of Maxillofacial Surgery (Medical Director: Prof. Dr. Dr. Peter Sieg), University of Luebeck, Germany. Electronic address: Hans-Christian.Jacobsen@uk-sh.de.
authors: Hans-Christian
authors: HC
authors: Jacobsen
authors: Samer G
authors: SG
authors: Hakim
authors: Thomas
authors: T
authors: Trenkle
authors: Martin
authors: M
authors: Nitschke
authors: Philipp
authors: P
authors: Steven
authors: Peter
authors: P
authors: Sieg
mesh_terms: D000328:Adult; D064591:Allografts / Q000637:transplantation*; D046528:Chimerism; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000150:complications; D006680:HLA Antigens / Q000032:analysis; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D013363:Submandibular Gland / Q000637:transplantation*; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014985:Xerophthalmia / Q000209:etiology / Q000601:surgery*
chemical_list: D006680:HLA Antigens
keywords: Allogenic transplantation; Dry eye; Graft-versus-host disease; Micro surgery; Submandibular gland