First human face allograft: early report

Devauchelle, Bernard; Badet, Lionel; Lengelé, Benoît; Morélon, Emmanuel; Testelin, Sylvie; Michallet, Mauricette; d’Hauthuille, C.; Dubernard, Jean‐Michel

doi:10.1016/s0140-6736(06)68935-6

Cited by 589 publications

(379 citation statements)

References 25 publications

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“…Two patients suffered from neurofibromatosis and consequent paralysis of almost the entire face (30,33), whereas the extent of damaged functional structures in the remaining six patients varied significantly. Absence of depressor muscles (20,36), upper lip (22), orbicularis oris (26,35) or other oral muscles (32) as well as impaired labial competence (27,34,36) suggests an inability to smile or to grimace properly before FT. Posttransplant follow-up reports stated successful reinnervation of facial muscles, the earliest after 3 months (27,33) as well as absent reinnervation after 2 years due to failed nerve anastomosis (22). Two patients regain symmetrical smiles after 6 and 18 months (21,26) and four patients demonstrated spontaneous mimicry (27,33) or emotional readability (35) 5-12 months after FT.…”

Section: Facial Expressionmentioning

confidence: 99%

Functional Outcomes of Face Transplantation

Fischer

Kueckelhaus

Pauzenberger

et al. 2015

American Journal of Transplantation

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In this study we provide a compilation of functional impairments before and improvements after face transplantation (FT) of five FT recipients of our institution and all FTs reported in current literature. Functional outcome included the ability to smell, breath, eat, speak, grimace and facial sensation. Before FT, all our patients revealed compromised ability to breath, eat, speak, grimace and experience facial sensation. The ability to smell was compromised in two of our five patients. Two patients were dependent on tracheostomy and one on gastrostomy tubes. After FT, all abilities were significantly improved and all patients were independent from artificial air airways and feeding tubes. Including data given in current literature about the other 24 FT recipients in the world, the abilities to smell, eat and feel were enhanced in 100% of cases, while the abilities of breathing, speaking and facial expressions were ameliorated in 93%, 71% and 76% of cases, respectively. All patients that required gastrostomy and 91% of patients depending on tracheostomy were decannulated after FT. Unfortunately, outcomes remain unreported in all other cases and therefore we are unable to comment on improvements.

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Section: Facial Expressionmentioning

confidence: 99%

Functional Outcomes of Face Transplantation

Fischer

Kueckelhaus

Pauzenberger

et al. 2015

American Journal of Transplantation

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“…The success of recent composite tissue allotransplantation is often attributed to improved microvascular techniques, but little consideration is given to the ongoing development of modern immunosuppressive techniques [26,27]. Siemionow's rat model of composite face transplantation and subsequent human cadaveric studies continue the search for tolerance induction with composite tissue allotransplantation.…”

Section: Immunosuppression For Composite Tissue Allotransplantationmentioning

confidence: 99%

Tongue Transplantation

John

Haughey

2014

Curr Otorhinolaryngol Rep

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The tongue is a vital organ that is integral to many basic human functions, such as speech and deglutition. The primary challenges in tongue reconstruction lie in its unique form and function, and complete functional rehabilitation is equally dependent on restoring sensory and motor functions. This review article discusses the background, history, and future of tongue reconstruction in the era of human tissue allotransplantation.

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“…These elements can function as a vascularized BM transplant by themselves [16][17][18], and provide a continuous source of donor-derived stem cells. The potential consequences of this phenomenon, however, can be either a favorable slowdown of rejection or an unfavorable risk factor for graft-versus-host disease (GvHD)-therefore, a dynamic balance of the two needs to be maintained for optimal outcomes.…”

Section: Bone Marrow and Vascularized Bone Marrow Nichementioning

confidence: 99%

Minimization of Immunosuppression and Tolerance Induction in Reconstructive Transplantation

et al. 2012

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Vascularized composite allotransplantation (VCA) is an innovative reconstructive modality for patients sustaining complex injuries not amenable to conventional treatment. Advances in immunosuppression have made VCA a clinical reality and a valid reconstructive option for such patients. The requirement, however, for multi-drug high-dose immunosuppressive regimens with their numerous side effects has hindered widespread clinical application of VCA. There is thus a need for novel immunologic modalities to minimize or even obviate the need for immunosuppression (tolerance induction) while still preserving the allograft and preventing rejection. Recent advances in targeted immunotherapy and cell-based protocols were able to achieve tolerance in selected cases of solid organ transplantation. This paved the way for innovative immunomodulatory protocols now also applied to VCA that aim for minimal immunosuppression or for induction of donor-specific tolerance. These concepts and novel protocols will be discussed in this review.

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First human face allograft: early report

Cited by 589 publications

References 25 publications

Functional Outcomes of Face Transplantation

Functional Outcomes of Face Transplantation

Tongue Transplantation

Minimization of Immunosuppression and Tolerance Induction in Reconstructive Transplantation

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