Facial transplantation: the first 9 years.
Since the first facial transplantation in 2005, 28 have been done worldwide with encouraging immunological, functional, psychological, and aesthetic outcomes. Unlike solid organ transplantation, which is potentially life-saving, facial transplantation is life-changing. This difference has generated ethical concerns about the exposure of otherwise young and healthy individuals to the sequelae of lifelong, high-dose, multidrug immunosuppression. Nevertheless, advances in immunomodulatory and immunosuppressive protocols, microsurgical techniques, and computer-aided surgical planning have enabled broader clinical application of this procedure to patients. Although episodes of acute skin rejection continue to pose a serious threat to face transplant recipients, all cases have been controlled with conventional immunosuppressive regimens, and no cases of chronic rejection have been reported.
Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA; Department of Plastic and Reconstructive Surgery, Reconstructive Transplantation Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Saami
S
Khalifian
Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.
Philip S
PS
Brazio
Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.
Raja
R
Mohan
Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.
Cynthia
C
Shaffer
Department of Plastic and Reconstructive Surgery, Reconstructive Transplantation Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Gerald
G
Brandacher
Division of Transplant Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
Rolf N
RN
Barth
Department of Plastic Surgery, Institute of Reconstructive Plastic Surgery, NYU Langone Medical Center, New York, NY, USA. Electronic address: eduardo.rodriguez@nyumc.org.
Eduardo D
ED
Rodriguez
D005145:Face / Q000294:innervation; D054445:Facial Transplantation / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use
D007166:Immunosuppressive Agents