Anaesthesia and Intensive Care Management of Face Transplantation

Sedaghati-Nia, A.; Gilton, A; Liger, C; Binhas, M.; Cook, Fabrice; Ait-Mammar, B.; Scherrer, E.; Hivelin, Mikaël; Lantieri, Laurent; Marty, Julien; Plaud, Benoît

doi:10.1097/01.sa.0000459225.85546.10

Cited by 7 publications

(30 citation statements)

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“…Postoperative severe graft edema is expected in most patients and head elevation at 30-45° will promote venous drainage and prevent VAP [ 1 ]. Extra care must be taken to avoid airway loss because that complication has devastating consequences.…”

Section: Airway Managementmentioning

confidence: 99%

“…Patients are ventilated with positive pressure volume controlled mode with FiO2 to keep paO2 levels between 100 and 150 mmHg [ 1 ]. Pulse oxymetry is helpful to wean or titrate FiO2; however, arterial blood gases are generally required to guide manage acid base balance.…”

Section: Ventilationmentioning

confidence: 99%

“…The most severe infections occur during times of over-immunosuppression, such as the induction phase or management of acute rejection. Cytomegalovirus (CMV), Epstein Barr virus (EBV), and cutaneous herpes simplex infections have been reported [ 1 ]. CMV can trigger rejection that can be challenging to control; therefore, ganciclovir must be administered based on donor and recipient data.…”

Section: Infections and Antibioticsmentioning

confidence: 99%

“…Proper levels of immunosuppression should minimize the risks of opportunistic infectious complications. A sentinel skin graft is placed sometimes in the left infra-mammary area to monitor rejection episodes [ 1 ]. Acute rejection has been reported as early as 4 days postgrafting.…”

Section: Immunosuppressionmentioning

confidence: 99%

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Postoperative Management of Composite Tissue Graft Transplantation

Sen

Al-Baghdadi

Al‐Khafaji

2016

Anesthesia and Perioperative Care for Organ Transplantation

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Stress Ulcer ProphylaxisStress related mucosal injury occurs in ICU patients within the fi rst few days of ICU admission. The most important risk factors for the development of gastrointestinal bleeding are coagulopathy and need for mechanical ventilation. Other risk factors include history of gastrointestinal bleeding, hypotension, and multi-organ system dysfunction. Most of these risk factors are common in prior to and in the immediate

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Section: Airway Managementmentioning

confidence: 99%

Section: Ventilationmentioning

confidence: 99%

Section: Infections and Antibioticsmentioning

confidence: 99%

Section: Immunosuppressionmentioning

confidence: 99%

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Postoperative Management of Composite Tissue Graft Transplantation

Sen

Al-Baghdadi

Al‐Khafaji

2016

Anesthesia and Perioperative Care for Organ Transplantation

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“…Owing to the complexity of facial transplantation surgery as well as the haemorrhagic risk, obtaining adequate vascular access is an important element that requires careful consideration. Femoral lines not only provide a good mode of intraoperative monitoring but also abide in keeping the surgical field clear [16]. This is an important anatomical consideration.…”

Section: Anaesthetic Assessmentmentioning

confidence: 99%

Basics of Facial Transplantation: Surgical Principles and Management of Risks

Rahman¹,

Shanmugarajah²,

Hettiaratchy³

et al. 2016

A Textbook of Advanced Oral and Maxillofacial Surgery Volume 3

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Facial transplantation offers an alternative approach towards restoring gross facial disfigurement. Since its advent in 2005, the surgical principles have become continually refined depending on the nature of the injury and anatomical requirements posed by the recipients. Owing to the complex nature of the procedure, it bears a number of different risks. These have included graft rejection from alloimmune responses, complications from the effects of immunosuppression and risk of mortality; in addition, there is an inherent predisposition for the development of psychological complications. This chapter outlines the stepwise process of conducting a facial transplantation with emphasis on key surgical principles. It also provides details with case examples of how to minimize complications associated with the procedure.

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Transplantation faciale : anesthésie et autres considérations organisationnelles

Bélanger

Borsuk

Clairoux

et al. 2021

Can J Anesth/J Can Anesth

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In 2005, the first facial vascularized composite allotransplant was performed in France. In May 2018, our team at Maisonneuve-Rosemont Hospital, Montreal, Quebec, had the privilege to participate in the first facial transplant in Canada. Interdisciplinary collaboration, coordination, and communication formed the cornerstone of this medical undertaking and, ultimately, its success. This report details the anesthetic and organizational considerations of our experience.Résumé En 2005, la premie`re allogreffe de tissu composite vascularise´e faciale e´tait re´alise´e en France. En mai 2018, notre e´quipe a`l'Hôpital Maisonneuve-Rosemont, a`Montre´al, au Que´bec, a eu le privile`ge de participer a`la premie`re greffe faciale au Canada. La collaboration, la coordination et la communication interdisciplinaires ont constitue´les pierres angulaires de ce projet me´dical et, ultimement, de son succe`s. Ce compte-rendu de´taille les conside´rations anesthe´siques et organisationnelles de notre expe´rience.

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Anaesthesia and Intensive Care Management of Face Transplantation

Cited by 7 publications

References 0 publications

Postoperative Management of Composite Tissue Graft Transplantation

Postoperative Management of Composite Tissue Graft Transplantation

Basics of Facial Transplantation: Surgical Principles and Management of Risks

Transplantation faciale : anesthésie et autres considérations organisationnelles

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