title: Facial transplantation in a blind patient: psychologic, marital, and family outcomes at 15 months follow-up.
abstract: BACKGROUND
  Quality of life has frequently been reported to improve after vascularized composite allotransplantation of the face. However, psychosocial functioning of the partner or of particular patient groups such as blind patients are until now less well investigated.
  
  
  OBJECTIVE
  The aim of this study is to investigate psychologic, marital, and family functioning of a blind 54-year-old patient, Mr. A, and his partner after facial transplantation.
  
  
  METHODS
  Depressive and anxiety symptoms, hopelessness, personality, coping, resilience, illness cognitions, marital support, dyadic adjustment, family functioning, and quality of life of Mr. A and his partner were assessed before and after facial transplantation and at 15 months follow-up. Reliable change index (RCI) was further calculated to evaluate the magnitude of change.
  
  
  RESULTS
  Most psychologic, marital, and family scores of both Mr. A and his partner were within a normative and healthy range before and after transplant and at 15 months follow-up. Resilience (RCI: 3.6), affective responsiveness (RCI: -3.6), and disease benefits (RCI: 2.6) of Mr. A further improved at 15 months follow-up whereas the physical quality of life (RCI: -14.8) strongly decreased. Only marital support (RCI: -2.1) and depth (RCI: -2.0) of the partner decreased at 15 months.
  
  
  CONCLUSIONS
  The results of this study point to positive psychosocial outcomes in a blind patient after facial transplantation. Further, they may underscore the importance of good psychosocial functioning before transplantation of both partners and of their involvement in psychologic and psychiatric treatment.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: Department of Psychiatry, Ghent University Hospital, Ghent, Belgium (GMDL). Electronic address: gilbert.lemmens@ugent.be.
authors.forename: Gilbert M D
authors.initials: GM
authors.lastname: Lemmens
authors.affiliation: Department of General and Hepato-Biliary Surgery and Transplantation, Transplantation Centre, Ghent University Hospital, Ghent, Belgium (CP, XR).
authors.forename: Carine
authors.initials: C
authors.lastname: Poppe
authors.affiliation: Burn Unit, Ghent University Hospital, Ghent, Belgium (HH).
authors.forename: Hannelore
authors.initials: H
authors.lastname: Hendrickx
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium (NAR, PNB).
authors.forename: Nathalie A
authors.initials: NA
authors.lastname: Roche
authors.affiliation: Department of Nephrology, Ghent University Hospital, Ghent, Belgium (PCP).
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Peeters
authors.affiliation: Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium (HFV).
authors.forename: Hubert F
authors.initials: HF
authors.lastname: Vermeersch
authors.affiliation: Department of Speech, Language and Hearing Sciences, University of Ghent, Ghent, Belgium (KVL).
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
authors.affiliation: Department of Speech, Language and Hearing Sciences, University of Ghent, Ghent, Belgium (KVL).
authors.forename: Kristiane Van
authors.initials: KV
authors.lastname: Lierde
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium (NAR, PNB).
authors.forename: Phillip N
authors.initials: PN
authors.lastname: Blondeel
mesh_terms: D000223:Adaptation, Psychological; D001766:Blindness / Q000523:psychology*; D054445:Facial Transplantation / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D018454:Spouses / Q000523:psychology