title: Quality of Life after Face Transplantation: Outcomes, Assessment Tools, and Future Directions.
abstract: BACKGROUND
  Face transplantation has emerged as a clinical reality for the restoration of complex facial defects. Critical to the advancement of the burgeoning field of reconstructive transplantation is the quality of the methods used to measure and report the impact of face transplantation on quality of life.
  
  
  METHODS
  A systematic search using PubMed and EMBASE was conducted for all studies matching the a priori inclusion criteria from 2005 through 2015. Bibliographies of included studies were also reviewed. Two authors (M.A.A and H.K) independently performed screening of titles.
  
  
  RESULTS
  The authors identified 17 articles reporting on quality-of-life outcomes among 14 face transplant recipients. Combinations of objective and subjective measures were used to assess quality of life. Instruments used to assess quality of life after face transplantation included over 25 different instruments. Four centers, comprising eight patients, have reported using prospective, systematic data with validated instruments. Overall, there is reported improvement in quality of life after face transplantation. Heterogeneity and a paucity of data between articles preclude a quantitative analysis.
  
  
  CONCLUSIONS
  Anecdotal and subjective reports of improvements in quality of life after face transplantation constitute the majority of reported outcomes in the English peer-reviewed literature. Improved efforts in methods and standardization of collection and reporting of quality-of-life data after face transplantation are needed to better appreciate the impact of face transplantation on quality of life and justify lifelong immunosuppression and its attendant risks and morbidity.
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Aycart
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Harriet
authors.initials: H
authors.lastname: Kiwanuka
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Nicco
authors.initials: N
authors.lastname: Krezdorn
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Muayyad
authors.initials: M
authors.lastname: Alhefzi
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Ericka M
authors.initials: EM
authors.lastname: Bueno
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Bohdan
authors.initials: B
authors.lastname: Pomahac
authors.affiliation: Boston, Mass.|From the Department of Surgery, Division of Plastic Surgery, and the Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Oser
mesh_terms: D054445:Facial Transplantation; D006305:Health Status Indicators; D006801:Humans; D011788:Quality of Life