title: Outcomes of Solid Organ Transplants After Simultaneous Solid Organ and Vascularized Composite Allograft Procurements: A Nationwide Analysis.
abstract: Current knowledge of the impact of facial vascularized composite allograft (VCA) procurement on the transplantation outcomes of the concomitantly recovered solid organs is limited to isolated case reports and short-term results. Here we report on a nationwide analysis of facial allograft donor surgery experience and long-term outcomes of the concomitantly recovered solid organs and their recipients.
  
  
  
  There were 10 facial VCA procurements in organ donors between December 2008 and October 2014. We identified the population of subjects who received solid organs from these 10 donors using the Scientific Registry of Transplant Recipients. We retrospectively reviewed operative characteristics, intraoperative parameters, and postoperative outcomes.
  
  
  
  Six of 10 donor surgeries were performed at outside institutions, all on brain-dead donors. Mean operative duration for facial VCA recovery was 6.9 hours (range, 4-13.25 hours). A total of 36 solid organs were recovered and transplanted into 35 recipients. Survival rates for kidney and liver recipients were 100% and 90% at a median follow-up of 33 and 27.5 months, respectively (range, 6-72 months). Graft survival rates for kidneys and livers were 15 of 16 (94%) and 9 of 10 (90%), respectively. Recipient and graft survival rates for hearts and lungs were 75% (n = 4) and 100% (n = 3) at mean follow-up time of 14.75 and 16 months, respectively. A liver recipient died at 22 months from unknown causes and a heart recipient died of leukemia at 10 months.
  
  
  
  Facial VCA procurement does not appear to adversely affect the outcomes of transplant recipients of concomitantly recovered solid organ allografts.
authors.affiliation: 1 Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 2 Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 3 Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Aycart
authors.forename: Muayyad
authors.initials: M
authors.lastname: Alhefzi
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sharma
authors.forename: Nicco
authors.initials: N
authors.lastname: Krezdorn
authors.forename: Ericka M
authors.initials: EM
authors.lastname: Bueno
authors.forename: Simon G
authors.initials: SG
authors.lastname: Talbot
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carty
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Tullius
authors.forename: Bohdan
authors.initials: B
authors.lastname: Pomahac
mesh_terms: D000328:Adult; D064595:Composite Tissue Allografts; D054445:Facial Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016377:Organ Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult