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Vascularized composite allotransplantation

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215 papers 25 to 100 followers Includes face, upper limb and hand, uterine and penile transplantation
By Mafer Amber QxMD ambassador, Mexican med student currently in 4° year, doing clinical research in vascularized composite allotransplantation
Kavit R Amin, Jason K F Wong, James E Fildes
An important and often underinvestigated contributor to solid organ transplant rejection is ischemia reperfusion injury. This pathophysiological response releases damaging reactive oxygen species and cell stress signals that initiate inflammation, which has a critical role in priming the immune system for allorecognition. In time, this renders graft dysfunction and how this response is mediated in composite tissues remains unknown. Current protocols are drawn from solid organ transplantation with little scientific basis as to how this informs current hand transplantation practices...
December 2017: Journal of Hand Surgery
Mitchell A Pet, Angelo B Lipira, Yusha Liu, Dennis Kao, Jason H Ko
BACKGROUND: Surgical options for the unreconstructable elbow are limited to arthrodesis, total arthroplasty, or osteoarticular allograft reconstruction. Each of these options is limited by severe functional impairment and/or high complication rates. Vascularized allotransplantation of the elbow joint has the potential to mitigate these complications. In this study, we describe our technique for harvesting the elbow for vascularized joint transplantation and demonstrate the flap's vascularity using contrast angiography...
January 9, 2018: Annals of Plastic Surgery
Ömer Özkan, Özlenen Özkan, Mehmetcan Ubur, Necmiye Hadimioğlu, Melike Cengiz, İsmail Afşar
BACKGROUND: The aim of this report is to present our long-term experiences with a series of 5 face-transplanted patients in terms of surgical aspects and postoperative outcomes, and to describe possible salvage strategies in case of difficulties. METHODS: Five patients, 4 receiving full-face transplantation and 1 undergoing partial transplantation at our institution were included. The patients were aged between 19 and 54 years. Two had extensive burn scars to the face, and 3 had suffered gunshot injuries...
November 27, 2017: Microsurgery
Patrik Lassus, Andrew Lindford, Jyrki Vuola, Leif Bäck, Sinikka Suominen, Karri Mesimäki, Tommy Wilkman, Tuija Ylä-Kotola, Erkki Tukiainen, Hannu Kuokkanen, Jyrki Törnwall
BACKGROUND: Since 2005, at least 38 facial transplantations have been performed worldwide. We herein describe the surgical technique and 1-year clinical outcome in Finland's first face transplant case. METHODS: A 34-year-old male who had a severe facial deformity following ballistic trauma in 1999 underwent facial transplantation at the Helsinki University Hospital on 8th February 2016. Three-dimensional (3D) technology was used to manufacture donor and recipient patient-specific osteotomy guides and a donor face mask...
February 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Hannelore Hendrickx, Phillip N Blondeel, Hanna Van Parys, Nathalie A Roche, Patrick C Peeters, Hubert F Vermeersch, Xavier Rogiers, Kristiane Van Lierde, Gilbert M D Lemmens
Increasing evidence points to good functional, aesthetic, and psychosocial outcomes after face transplantation. However, research investigating how patients and their families subjectively experience the transplantation process is lacking thus far. This study aims to investigate the personal experiences of a blind face transplant patient and his partner. In-depth interviews exploring different experiences were conducted with both partners separately 20 months after face transplantation. The interviews were analyzed using interpretative phenomenological analysis...
January 4, 2018: Journal of Craniofacial Surgery
Nima Khavanin, Edward H Davidson, Diana Y Lee, Patrick Byrne, Amir H Dorafshar
Concomitant temporomandibular joint (TMJ) transplantation is an obvious advancement in the reconstructive armamentarium for face transplantation in scenarios involving TMJ ankylosis. This study investigates the fidelity of mandibular morphology and explores the feasibility of bilateral mandibular condyle transfer in facial vascularized composite allotransplantation. Geometric analysis was performed on 100 skeletally mature maxillofacial computed tomography scans. Exclusion criteria included mandibular trauma and dentoalveolar disease...
March 1, 2018: Journal of Craniofacial Surgery
Merve Bedeloglu, Çagdas Topcu, Arzu Akgul, Ela Naz Döger, Refik Sever, Ozlenen Ozkan, Omer Ozkan, Hilmi Uysal, Ovunc Polat, Omer Halil Çolak
In this study, it is aimed to determine the degree of the development in emotional expression of full face transplant patients from photographs. Hence, a rehabilitation process can be planned according to the determination of degrees as a later work. As envisaged, in full face transplant cases, the determination of expressions can be confused or cannot be achieved as the healthy control group. In order to perform image-based analysis, a control group consist of 9 healthy males and 2 full-face transplant patients participated in the study...
January 20, 2018: Journal of Medical Systems
William Gaetz, Sudha K Kessler, Tim P L Roberts, Jeffrey I Berman, Todd J Levy, Michelle Hsia, Deborah Humpl, Erin S Schwartz, Sandra Amaral, Ben Chang, Lawrence Scott Levin
In this repeated measures case study, we show that sensory deafferentation after limb amputation leads to changes in cortical somatotopic maps which are reversible after restoration of sensory input. Using magnetoencephalography (MEG), we observed in a child with bilateral hand transplants large-scale shifts in somatosensory lip cortical representation from anatomic hand area to anatomic face region. After recovery of tactile sensation in the digits, responses to finger stimulation were localized to orthotopic sensory cortex, but with atypical electrophysiologic features (amplitude and frequencies)...
January 2018: Annals of Clinical and Translational Neurology
Annalisa Cogliandro, Mauro Barone, Rosa Salzillo, Paolo Persichetti
No abstract text is available yet for this article.
November 2017: Plastic and Reconstructive Surgery
Jérôme Duisit, Louis Maistriaux, Alexander Gerdom, Martial Vergauwen, Pierre Gianello, Catherine Behets, Benoît Lengelé
BACKGROUND: In the field of Vascularized Composite tissue Allotransplantation (VCA), the surgical design of facial subunit grafts is an evolving concept. The purpose of the present paper is to study the possibilities to divide the historical nose and lips face transplant into several morphological and functional subunit grafts, depending on their respective supply. METHODS: Our study was conducted in 20 adult cadavers. The facial artery and its branches were dissected bilaterally in 16 fresh and 4 embalmed heads...
November 11, 2017: Plastic and Reconstructive Surgery
Francesco Simonacci, Roberto Toni, Edoardo Raposio
BACKGROUND/AIM: Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field...
2017: Annali Italiani di Chirurgia
Yur-Ren Kuo, Chien-Chang Chen, Yen-Chou Chen, Ching-Ming Chien
Donor mesenchymal stem cells (MSCs) could prolong vascularized composite allotransplantation (VCA) survival in our previous studies. However, recipient adipose tissue is easier to harvest than donor tissue for preconditioning modulation. Hence, this study investigated the efficacy of recipient autologous adipose-derived stem cells (rADSCs) for VCA survival. The heterotopic hind-limb transplantation from female donor to male recipient was performed in outbred miniature swine. Group I ( n = 6) was untreated controls...
August 2017: Cell Transplantation
Katlin B Stivers, Jason E Beare, Paula M Chilton, Stuart K Williams, Christina L Kaufman, James B Hoying
PURPOSE OF REVIEW: Controlling acute allograft rejection following vascularized composite allotransplantation requires strict adherence to courses of systemic immunosuppression. Discovering new methods to modulate the alloreactive immune response is essential for widespread application of vascularized composite allotransplantation. Here, we discuss how adipose-derived cellular therapies represent novel treatment options for immune modulation and tolerance induction in vascularized composite allotransplantation...
October 2017: Current Opinion in Organ Transplantation
Vilmos Bíró
The author summarizes briefly the history of hand allograft transplantation, the basics of the operative technics, and the medicinal treatment of the immunosuppression. He establishes that this operation requires complicated team-work: many specialists must be united in the interest of the successful final outcome. The biggest problem is not the technical challenge of the complicated operation, but the ineffectiveness of immunosuppression, its complications; even though significant development has happened in this field and experimental results are also encouraging...
September 2017: Orvosi Hetilap
Rachel G Lopdrup, Marvee Turk, Thet Su Win, Francisco M Marty, David Molway, Stefan G Tullius, Bohdan Pomahac, Simon G Talbot
No abstract text is available yet for this article.
October 2017: Transplantation
Lars Dahlin, Marianne Arner, Per Fredrikson, Tobias Laurell, Sassu Paolo, Jonas Wadström, Mikael Wiberg
English summary: Hand transplantation in Sweden - preparations under way Some patients with a uni- or bilateral hand- or forearm amputation cannot use a hand prosthesis, although high-tech prostheses have been developed. A hand transplantation, particularly for those with bilateral amputations, may be an alternative solution. In a hand-transplanted patient, grip function, strength, sensibility and subsequent improved quality of life can be restored. Risks related to immunosuppression must be balanced by expected benefits, and thorough selection of patients has to be performed from both medical and psychological point of view...
September 25, 2017: Läkartidningen
Kenneth F Valyear, Daniela Mattos, Benjamin A Philip, Christina Kaufman, Scott H Frey
Hand loss can now be reversed through surgical transplantation years or decades after amputation. Remarkably, these patients come to use their new hand to skilfully grasp and manipulate objects. The brain mechanisms that make this possible are unknown. Here we test the hypothesis that the anterior intraparietal cortex (aIPC) - a multimodal region implicated in hand preshaping and error correction during grasping - plays a key role in this compensatory grasp control. Motion capture and fMRI are used to characterize hand kinematics and brain responses during visually guided grasping with a transplanted hand at 26 and 41 months post-transplant in patient DR, a former hand amputee of 13 years...
September 28, 2017: NeuroImage
Carisa M Cooney, Charalampos Siotos, Jeffrey W Aston, Ricardo J Bello, Stella M Seal, Damon S Cooney, Jaimie T Shores, Gerald Brandacher, W P Andrew Lee
PURPOSE: We conducted a systematic review to document ethical concerns regarding human upper extremity (UE) allotransplantation and how these concerns have changed over time. METHODS: We performed a systematic review of 5 databases to find manuscripts addressing ethical concerns related to UE allotransplantation. Inclusion criteria were papers that were on the topic of UE allotransplantation, and related ethical concerns, written in English. We extracted and categorized ethical themes under the 4 principles of bioethics: Autonomy, Beneficence, Nonmaleficence, and Justice...
October 4, 2017: Journal of Hand Surgery
Deepak Bharadia, Indranil Sinha, Bohdan Pomahac
Face transplantation can provide improved quality of life to patients with extensive burn injuries. Facial vascularized composite allotransplantation (VCA) offers a new paradigm of treatment options, serving as a powerful reconstructive tool to restore facial form and function. Although currently facial VCA patients must follow a lifelong regimen of immunosuppression medications and suffer a risk of rejection, in properly selected patients, facial VCA can be a transformative operation and can improve quality of life...
October 2017: Clinics in Plastic Surgery
Michael Sosin, Gerhard S Mundinger, Cinthia B Drachenberg, Eduardo D Rodriguez
BACKGROUND: The purpose of this study was to investigate whether lymphatic reconstitution and regeneration occurs after clinical facial transplantation using indocyanine green lymphography and immunohistochemical markers. METHODS: Allograft skin biopsies at multiple posttransplant time points were stained with Lyve1 lymphatic antibody and other endothelial antibodies. Staining intensity was interpreted on a scale of none, mild, moderate, and strong by 2 investigators and consolidated by a third party for final interpretation...
November 2017: Annals of Plastic Surgery
2017-10-21 19:07:12
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