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139 papers 25 to 100 followers Vascularized composite allotransplantation of the face
By Mafer Amber QxMD ambassador, Mexican med student currently in 4° year, doing clinical research in vascularized composite allotransplantation
https://www.readbyqxmd.com/read/29051396/facial-transplantation-an-update-of-results-and-perspectives-from-tissue-engineering
#1
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
https://www.readbyqxmd.com/read/28888310/role-of-facial-vascularized-composite-allotransplantation-in-burn-patients
#2
REVIEW
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
https://www.readbyqxmd.com/read/28953521/lymphatic-reconstitution-and-regeneration-after-face-transplantation
#3
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
https://www.readbyqxmd.com/read/28985877/intra-graft-injection-of-tacrolimus-promotes-survival-of-vascularized-composite-allotransplantation
#4
Radu Olariu, Julie Denoyelle, Franck M Leclère, Dzhuliya V Dzhonova, Thusitha Gajanayake, Yara Banz, Michael Hayoz, Mihai Constantinescu, Robert Rieben, Esther Vögelin, Adriano Taddeo
BACKGROUND: Immunosuppressive therapies derived from solid organ transplantation are effective in promoting survival of vascularized composite allotransplantation (VCA), but they cause serious side effects that are difficult to justify for this non-life-saving procedure. Unlike solid organ transplantation, hand and face transplants offer the possibility of site-specific immunosuppression for reducing systemic exposure while increasing intra-graft concentrations of the drug. Therefore, in this study, we tested whether a single intra-graft injection tacrolimus could promote VCA survival...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/21554424/achievements-and-challenges-in-composite-tissue-allotransplantation
#5
REVIEW
Stefan Schneeberger, Luis Landin, Jerzy Jableki, Peter Butler, Christoph Hoehnke, Gerald Brandacher, Emmanuel Morelon
Overall, more than 60 hand/forearm/arm transplantations and 16 face transplantations have been performed in the past 12 years. In the European experience summarized here, three grafts have been lost in response to a vascular thrombosis (n = 1), rejection and incompliance with immunosuppression (n = 1) and death (n = 1). The overall functional and esthetic outcome is very satisfactory, but serious side effects and complications related to immunosuppression are challenges hindering progress in this field. The high levels of immunosuppression, skin rejection, nerve regeneration, donor legislation and the acceptance level need to be addressed to promote growth of this promising new field in transplantation and reconstructive surgery...
August 2011: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28845920/ethical-issues-in-pediatric-face-transplantation
#6
Ana-Gabriela Benghiac, Jeremy R Garrett, Brian S Carter
Facial transplantation has become a reality in adult medicine. Children are subject to congenital craniofacial differences, disease-related, traumatic, or thermochemical craniofacial changes and might be suitable for face transplantation. This manuscript addresses unique ethical issues in considering potential pediatric face transplant. These challenges are operant at the individual, technologic, and psychosocial level for clinicians, investigators, and society.
November 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28742686/bioengineering-a-human-face-graft-the-matrix-of-identity
#7
Jérôme Duisit, Louis Maistriaux, Adriano Taddeo, Giuseppe Orlando, Virginie Joris, Emmanuel Coche, Catherine Behets, Jan Lerut, Chantal Dessy, Giulio Cossu, Esther Vögelin, Robert Rieben, Pierre Gianello, Benoît Lengelé
OBJECTIVE: During the last decade, face allotransplantation has been shown to be a revolutionary reconstructive procedure for severe disfigurements. However, offer to patients remains limited due to lifelong immunosuppression. To move forward in the field, a new pathway in tissue engineering is proposed. BACKGROUND: Our previously reported technique of matrix production of a porcine auricular subunit graft has been translated to a human face model. METHODS: 5 partial and 1 total face grafts were procured from human fresh cadavers...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28717523/assessment-of-emotional-expressions-after-full-face-transplantation
#8
Çağdaş Topçu, Hilmi Uysal, Ömer Özkan, Özlenen Özkan, Övünç Polat, Merve Bedeloğlu, Arzu Akgül, Ela Naz Döğer, Refik Sever, Nur Ebru Barçın, Kadriye Tombak, Ömer Halil Çolak
We assessed clinical features as well as sensory and motor recoveries in 3 full-face transplantation patients. A frequency analysis was performed on facial surface electromyography data collected during 6 basic emotional expressions and 4 primary facial movements. Motor progress was assessed using the wavelet packet method by comparison against the mean results obtained from 10 healthy subjects. Analyses were conducted on 1 patient at approximately 1 year after face transplantation and at 2 years after transplantation in the remaining 2 patients...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/28662790/perioperative-nursing-management-of-donor-and-recipient-patients-undergoing-face-transplantation
#9
Nicole Sweeney, Kathryn Allen, Brooke Miller, Theresa Nolan, Kathleen Sheerin
Individuals with debilitating facial injuries and deformities have achieved significant improvement of aesthetic form and function after undergoing a face transplantation. The involvement of surgical technologists and perioperative nurses in the care of the recipient and donor plays a critical role in the success of these procedures. There are unique challenges that staff members may be presented with when caring for a donor and recipient undergoing a face transplantation, including less comfort with and knowledge of the surgical procedure and instrumentation, an increased amount of equipment and personnel in the OR, donor and recipient admission and discharge care, and increased shift length...
July 2017: AORN Journal
https://www.readbyqxmd.com/read/28679959/longitudinal-immunological-characterization-of-the-first-presensitized-recipient-of-a-face-transplant
#10
Thet Su Win, Naoka Murakami, Thiago J Borges, Anil Chandraker, George Murphy, Christine Lian, Victor Barrera, Shannan Ho Sui, David Schoenfeld, Jessica Teague, Ericka Bueno, Stefan G Tullius, Bohdan Pomahac, Rachael A Clark, Leonardo V Riella
Rejection affects greater than 80% of face transplants, yet no diagnostic criteria for antibody-mediated rejection (AMR) following face transplantation have been established. Given that different treatment strategies are required to address AMR and T cell-mediated rejection (TCMR), there is a critical need to delineate the features that can differentiate these two alloimmune responses. Here, we report the longitudinal immunological examination of what we believe to be the first and only highly sensitized recipient of a crossmatch-positive face transplant up to 4 years following transplantation...
July 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28574951/single-artery-human-ear-graft-procurement-a-simplified-approach
#11
Jérôme Duisit, Hadrien Amiel, Donovan Debluts, Louis Maistriaux, Alexander Gerdom, Anne Bol, Pierre Gianello, Catherine Behets, Benoit Lengelé
In the field of experimental facial vascularized composite tissue allotransplantation, a human auricular subunit model, pedicled on both superficial temporal and posterior auricular arteries, was described. Clinical cases of extensive auricular replantation, however, suggested that a single artery could perfuse the entire flap. In this study, variants of this single-pedicle approach have been studied, aiming to develop a more versatile replantation technique, in which the question of venous drainage has also been addressed...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28493355/consideration-of-difficulties-and-exit-strategies-in-a-case-of-face-allotransplantation-resulting-in-failure
#12
Özlenen Özkan, Ömer Özkan, Umuttan Doğan, Vural Taner Yılmaz, Hilmi Uysal, Levent Ündar, Ebru Apaydın Doğan, Ozan Salim, Anı Çinpolat, Atilla Ramazanoglu
We describe the first rescue procedure in a case of total face allotransplantation. The recipient was a 54-year-old man with severe disfigurement of the entire face following an accidental gunshot injury 5 years previously. The large defect included the maxilla, mandible, and mid-face. Full face procurement was performed from a multiorgan cadaveric donor and was allotransplanted to the recipient. The post-transplant induction immunosuppressive regimen included ATG combined with tacrolimus, mycophenolate mofetil, and prednisone, while maintenance was provided by the last three of these...
September 2017: Microsurgery
https://www.readbyqxmd.com/read/28445377/first-lower-two-thirds-osteomyocutaneous-facial-allograft-perfused-by-a-unilateral-facial-artery-outcomes-and-vascularization-at-1-year-after-transplantation
#13
Sebastian Fischer, Thomas C Lee, Nicco Krezdorn, Muayyad Alhefzi, Maximilian Kueckelhaus, Ericka M Bueno, Bohdan Pomahac
BACKGROUND: Facial allotransplantation provides a unique opportunity to restore facial form and function in severely disfigured patients. Using a single unilateral facial artery for vascularization can significantly reduce surgical duration and thus facilitate the practice of face transplantation. METHODS: A 33-year-old man with a history of high-energy ballistic trauma received a facial allograft comprising the lower two-thirds of the face, including maxilla and mandible...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28390109/vascularized-composite-allograft-donation-and-transplantation-a-survey-of-public-attitudes-in-the-united-states
#14
J R Rodrigue, D Tomich, A Fleishman, A K Glazier
Vascularized composite allograft (VCA) transplantation has emerged as a groundbreaking surgical intervention to return identity and function following traumatic injury, congenital deformity, or disfigurement. While public attitudes toward traditional organ/tissue donation are favorable, little is known about attitudes toward VCA donation and transplantation. A survey was conducted of 1485 U.S. residents in August 2016 to assess VCA donation attitudes. Participants also completed the Revised Health Care System Distrust Scale...
April 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28371289/prolonged-cold-ischemia-time-results-in-local-and-remote-organ-dysfunction-in-a-murine-model-of-vascularized-composite-transplantation
#15
N Datta, S G Devaney, R W Busuttil, K Azari, J W Kupiec-Weglinski
Vascularized composite allotransplantation (VCA) is a viable reconstructive option for complex tissue defects. Although grafts with a large muscular component may be uniquely susceptible to ischemia-reperfusion (I/R) syndrome, the safe cold ischemia time in VCA has not been established. We investigated the effects of cold ischemia on innate immune response and recipient survival in a murine orthotopic hindlimb transplantation model. Surprisingly, mice receiving grafts exposed to 6 h or longer of cold storage demonstrated reduced survival and massive elevations in serum creatinine, blood urea nitrogen, and creatine kinase, compared with 1 h of cold storage recipients...
March 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28371193/chronic-allograft-deterioration-a-clinical-reality-in-vascularized-composite-allotransplantation
#16
EDITORIAL
N Krezdorn, B Pomahac
No abstract text is available yet for this article.
July 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28303433/the-decade-of-face-transplant-outcomes
#17
REVIEW
Maria Siemionow
At the 10th year anniversary of the first face transplantation, 37 patients worldwide, were the recipients of faces coming from human donors. Five patients died due to complications, noncompliance with immunosuppressive medications and development of cancer. Despite the initial debates and ethical concerns, face transplantation became a clinical reality with satisfactory functional outcomes. The areas of controversy still include the impact of life-long immunosuppression on otherwise healthy patients as well as the selection process of face transplant candidates...
May 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28252516/decellularization-of-the-porcine-ear-generates-a-biocompatible-nonimmunogenic-extracellular-matrix-platform-for-face-subunit-bioengineering
#18
Jérôme Duisit, Giuseppe Orlando, Donovan Debluts, Louis Maistriaux, Daela Xhema, Yann-Alex J de Bisthoven, Cesare Galli, Andrea Peloso, Catherine Behets, Benoît Lengelé, Pierre Gianello
OBJECTIVE: The purpose of this study was to assess whether perfusion-decellularization technology could be applied to facial grafts. BACKGROUND: Facial allotransplantation remains an experimental procedure. Regenerative medicine techniques allow fabrication of transplantable organs from an individual's own cells, which are seeded into extracellular matrix (ECM) scaffolds from animal or human organs. Therefore, we hypothesized that ECM scaffolds also can be created from facial subunits...
March 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28141920/face-transplantation-partial-graft-loss-of-the-first-case-10-years-later
#19
E Morelon, P Petruzzo, J Kanitakis, S Dakpé, O Thaunat, V Dubois, G Choukroun, S Testelin, J-M Dubernard, L Badet, B Devauchelle
Ten years after the first face transplantation, we report the partial loss of this graft. After two episodes of acute rejection (AR) occurred and completely reversed in the first posttransplantation year, at 90 months posttransplantation the patient developed de novo class II donor-specific antibodies, without clinical signs of AR. Some months later, she developed several skin rejection episodes treated with steroid pulses. Despite rapid clinical improvement, some months later the sentinel skin graft underwent necrosis...
July 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28138125/face-transplant-in-an-advanced-neurofibromatosis-type-1-patient
#20
Łukasz Krakowczyk, Adam Maciejewski, Cezary Szymczyk, Krzysztof Oleś, Stanisław Półtorak
BACKGROUND The human face is a one-of-a-kind structure with unique morphology, complexity, and function, in which different subunits are not even similar to other parts of the body. Therefore, extended complex deficits of the face are usually difficult to reconstruct, and autologous tissue restoration is generally not able to give a satisfactory aesthetic and functional outcome. The main goal of face allotransplantation is to restore symmetry, contour, and appearance as well as function of the face, especially control of orbicularis oculi and oris muscle physiology...
January 31, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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