Five-Year Follow-up after Face Transplantation

Tasigiorgos, Sotirios; Kollar, Branislav; Turk, Marvee; Perry, Bridget J.; Alhefzi, Muayyad; Kiwanuka, Harriet; Nizzi, Marie-Christine; Marty, Francisco M.; Chandraker, Anil; Tullius, Stefan G.; Riella, Leonardo V.; Pomahac, Bohdan

doi:10.1056/nejmc1810468

Cited by 50 publications

(56 citation statements)

References 5 publications

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“…Vascularized composite allotransplantation (VCA) such as face and upper extremity (UE) transplantation can successfully restore form and function to patients with devastating injuries (1, 2). However, the transplantation of such complex tissues is associated with high rates of acute rejection (AR), reaching an incidence of more than 80% in the first postoperative year (3).…”

Section: Introductionmentioning

confidence: 99%

MMP3 Is a Non-invasive Biomarker of Rejection in Skin-Bearing Vascularized Composite Allotransplantation: A Multicenter Validation Study

et al. 2019

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Background: There is unmet need for non-invasive immunomonitoring to improve diagnosis and treatment of acute rejection in vascularized composite allotransplantation (VCA). Circulating matrix metalloproteinase 3 (MMP3) was described as a candidate non-invasive biomarker to predict treatment response to acute rejection in clinical VCA. However, larger validation studies are yet to be reported to allow for more definitive conclusions.Methods: We retrospectively measured MMP3 levels using ELISA in a total of 140 longitudinal serum samples from six internal and three external face transplant recipients, as well as three internal and seven external upper extremity transplant recipients. The control groups comprised serum samples from 36 kidney transplant recipients, 14 healthy controls, and 38 patients with autoimmune skin disease. A linear mixed model was used to study the effect of rejection state (pre-transplant, no-rejection, non-severe rejection (NSR), and severe rejection) on MMP3 levels.Results: In VCA, MMP3 levels increased significantly (p < 0.001) between pre- and post-transplant no-rejection states. A further increase occurred during severe rejection (p < 0.001), while there was no difference in MMP3 levels between non-severe and no-rejection episodes. A threshold of 5-fold increase from pre-transplant levels could discriminate severe from NSR with 76% sensitivity and 81% specificity (AUC = 0.79, 95% CI = 0.65–0.92, p < 0.001). In kidney transplantation, the MMP3 levels were significantly (p < 0.001) elevated during antibody-mediated rejection but not during T-cell mediated rejection (TCMR) (p = 0.547). MMP3 levels in healthy controls and autoimmune skin disease patients were comparable with either pre-transplant or no-rejection/NSR episodes of VCA patients.Conclusion: The results of this study suggest that serum MMP3 protein is a promising marker for stratifying patients according to severity of rejection, complementary to biopsy findings.

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Section: Introductionmentioning

confidence: 99%

MMP3 Is a Non-invasive Biomarker of Rejection in Skin-Bearing Vascularized Composite Allotransplantation: A Multicenter Validation Study

et al. 2019

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“…From postoperative month 14, patient 5 received belatacept in addition to the triple therapy. Steroids were completely weaned in 4 patients but reintroduced in 3 patients at 5 years of follow-up 2 .…”

Section: Methodsmentioning

confidence: 99%

“…Reconstructive transplantation such as face transplantation (FT) is a promising way to restore the functionality and social reintegration for severely disfigured patients 1,2 . More than forty such procedures have been performed world-wide to date 3 .…”

Section: Background and Summarymentioning

confidence: 99%

Blood proteome profiling using aptamer-based technology for rejection biomarker discovery in transplantation

et al. 2019

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Face transplantation is a promising solution for patients with devastating facial injuries who lack other satisfactory treatment options. At the same time, this type of transplantation is accompanied with high risks of acute transplant rejection. The limitations of traditional skin biopsy and the need to frequently monitor the condition of face transplant call for less invasive biomarkers to better diagnose and treat acute rejection. Discovery of peripheral serum proteins accurately reflecting the transplant status would represent a reasonable solution to meet this demand. However, to date, there is no clinical data available to address the feasibility of this approach. In this study, we used the next generation aptamer-based SOMAscan proteomics platform to profile 1305 proteins of peripheral blood serum in twenty-four samples taken from 6 patients during no-rejection, nonsevere rejection, and severe rejection episodes. Also, we provide a detailed description of biosample processing and all steps to generate and analyze the SOMAscan dataset with hope it will assist in performing biomarker discovery in other transplantation centers using this platform.

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“…1 In addition to widely publicised progress in the fields of hand and face transplantation, abdominal wall, uterus and penis transplantation are now showing considerable promise. [2][3][4][5][6] Despite encouraging clinical results the morbidity associated with long-term immunosuppression, an inability to prevent acute and chronic rejection episodes, and the limited life span of transplanted organs are starting to limit VCA progress and expansion in many units. [7][8][9] Efforts are now focussed on trying to reduce side-effects and prolong VCA function and survival.…”

Section: Introductionmentioning

confidence: 99%

Biomarker and surrogate development in vascularised composite allograft transplantation: Current progress and future challenges

Honeyman

Stark

Wang

et al. 2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Five-Year Follow-up after Face Transplantation

Cited by 50 publications

References 5 publications

MMP3 Is a Non-invasive Biomarker of Rejection in Skin-Bearing Vascularized Composite Allotransplantation: A Multicenter Validation Study

MMP3 Is a Non-invasive Biomarker of Rejection in Skin-Bearing Vascularized Composite Allotransplantation: A Multicenter Validation Study

Blood proteome profiling using aptamer-based technology for rejection biomarker discovery in transplantation

Biomarker and surrogate development in vascularised composite allograft transplantation: Current progress and future challenges

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