Accelerated chronic skin changes without allograft vasculopathy: A 10-year outcome report after face transplantation

Kollar, Branislav; Rizzo, Natalie M.; Borges, Thiago J.; Haug, Valentin; Abdulrazzak, Obada; Kauke, Martin; Safi, Ali-Farid; Lian, Christine G.; Marty, Francisco M.; Rutherford, Anna E.; Mitchell, Richard N.; Murphy, Gëorge F.; Tullius, Stefan G.; Riella, Leonardo V.; Pomahac, Bohdan

doi:10.1016/j.surg.2020.01.010

Cited by 30 publications

(24 citation statements)

References 29 publications

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“…Only six histologically proven cases of CR have been reported in the context of FT, in three case reports and one series. 10,11,15,17 The mean time from transplantation to CR in our series was similar to that reported by Krezdorn (52 ± 17 and 46 ± 21.5 months, respectively). We observed a higher incidence of CR (67% vs. 43%) that might be explained by a longer mean duration of follow-up (104 vs.…”

Section: Discussionsupporting

confidence: 90%

“…Foxp3/ CD3 ratio, median (IQR) 12.5 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) 20 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) .21…”

Section: Discussionunclassified

“…We then compared the distributions of cytotoxic effectors and regulatory T cells in the discordant and concordant groups (n = 41 and n = 17, respectively). The median length of the mucosal biopsy specimen (3 mm [2.3-3.7] and 3.4 mm [2.9-4], p = .25) and the median FoxP3/CD3 and GranzymeB/CD3 ratios (20% [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] vs. 25% [20][21][22][23][24][25][26][27][28][29][30], p = .81; 5% [1][2][3][4][5][6][7][8][9][10] vs. 5% [5][6][7][8][9][10][11][12][13][14][15], p = .15, respectively) were similar in the two groups (Table 3B).…”

Section: Densities Of Granzyme B + and Foxp3 + Intra-epithelial Cells In Mucosal Biopsy Specimens Are Significantly Higher In The Concordmentioning

confidence: 99%

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Face transplantation: A longitudinal histological study focusing on chronic active and mucosal rejection in a series with long-term follow-up

Moktefi

Hivelin

Grimbert

et al. 2021

American Journal of Transplantation

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The 2007 Banff working classification of skin-containing Tissue Allograft Pathology addressed only acute T cell-mediated rejection in skin. We report the longitudinal long-term histological follow-up of six face transplant recipients, focusing on chronic and mucosal rejection. We identified three patterns suggestive of chronic rejection (lichen planus-like, vitiligo-like and scleroderma-like). Four patients presented lichen planus-like and vitiligo-like chronic rejection at 52 ± 17 months posttransplant with severe concomitant acute T cell-mediated rejection. After lichen planus-like rejection, two patients developed scleroderma-like alterations. Graft vasculopathy with C4d deposits and de novo DSA led to subsequent graft loss in one patient. Chronic active rejection was frequent and similar patterns were noted in mucosae. Concordance between 124 paired skin and mucosal biopsies acute rejection grades was low (κ = 0.2,

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Section: Discussionsupporting

confidence: 90%

“…Foxp3/ CD3 ratio, median (IQR) 12.5 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) 20 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) .21…”

Section: Discussionunclassified

Section: Densities Of Granzyme B + and Foxp3 + Intra-epithelial Cells In Mucosal Biopsy Specimens Are Significantly Higher In The Concordmentioning

confidence: 99%

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Face transplantation: A longitudinal histological study focusing on chronic active and mucosal rejection in a series with long-term follow-up

Moktefi

Hivelin

Grimbert

et al. 2021

American Journal of Transplantation

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“…Although the majority of adherent patients under triple immunosuppressive therapy do not develop CR in the long term, 1,4,8,9 data from the literature and our own experience have highlighted changes suggestive of CR in some patients 1,10,11,16‐18 …”

Section: Discussionmentioning

confidence: 85%

Graft vasculopathy in upper extremity allotransplantation: Results of a retrospective high‐resolution ultrasonographic study

Petruzzo

Luong

Kanitakis

et al. 2020

Clinical Transplantation

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Graft vasculopathy (GV) is the most severe pathologic change of chronic rejection in vascularized composite allotransplantation. Since 2012, the intimal media thickness (IMT) of radial and ulnar arteries was annually monitored by high‐resolution ultrasonography in seven bilateral upper extremity transplant (UET) patients. We also investigated the IMT of seven matched healthy subjects (controls). No significant difference between IMT values of controls and UET patients was found. The median IMT values of recipient radial and ulnar arteries were 0.23 mm and 0.25 mm, respectively, while the median IMT values of grafted radial and ulnar arteries were 0.27 mm and 0.30 mm, respectively. There was a statistically significant difference in the IMT values of the grafted and recipient ulnar arteries (p = .043), but this difference was no longer significant when patient #2 was excluded. He showed a significant difference between recipient and grafted arteries and significantly higher IMT values (p = .001) of his grafted arteries compared with those of all transplanted patients. This patient developed GV leading to graft loss 11 years after the transplantation. In conclusion, this study showed a significant IMT increase in an UET recipient who developed GV.

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“… 1 Repeated T cell–mediated rejection and associated tissue insults were previously hypothesized to cause chronic skin changes in the absence of graft vasculopathy and donor-specific antibody. 2 We present a case in which repeated insults to the mucocutaneous junction of the nasal vestibulum caused a gradual loss of the right alar base of the nose.…”

Section: Introductionmentioning

confidence: 99%

Partial Loss of Nasal Tissue in a Facial Vascularized Composite Allograft Patient

Kauke

Tchiloemba

Haug

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Accelerated chronic skin changes without allograft vasculopathy: A 10-year outcome report after face transplantation

Cited by 30 publications

References 29 publications

Face transplantation: A longitudinal histological study focusing on chronic active and mucosal rejection in a series with long-term follow-up

Face transplantation: A longitudinal histological study focusing on chronic active and mucosal rejection in a series with long-term follow-up

Graft vasculopathy in upper extremity allotransplantation: Results of a retrospective high‐resolution ultrasonographic study

Partial Loss of Nasal Tissue in a Facial Vascularized Composite Allograft Patient

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