Severe Rhabdomyolysis After Allogeneic Transplantation of Facial Structures: A Case Report

Pérez, Rosalía Martínez; López, M. Porras; Escoresca‐Ortega, Ana; Avilés, Á. Herruzo; León, Antonio Martín; Noval, Jose Angel; Gómez-Cía, Tomás; Sicilia, D.; Padilla, Javier

doi:10.1016/j.transproceed.2010.08.007

Cited by 15 publications

(8 citation statements)

References 12 publications

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“…There was also a severe blood loss in our patient case (26), as 24 packed red blood cells units were transfused resulting in a post-transplant dilutional coagulopathy. It is interesting to note that our patient developed rhabdomyolysis after transplantation, which was attributed to both massive blood loss and to an intra-operative immobilization long period (18). …”

Section: Discussionmentioning

confidence: 88%

Facial transplantation: A concise update

Infante-Cossio

Barrera-Pulido²,

Gómez-Cía³

et al. 2013

Med Oral

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Objectives: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. Study design: MEDLINE search of articles published on “face transplantation” until March 2012. Results: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 8 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. Conclusions: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients. Key words:Face transplantation, composite tissue transplantation, face allograft, facial reconstruction, outcomes and complications of face transplantation.

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Section: Discussionmentioning

confidence: 88%

Facial transplantation: A concise update

Infante-Cossio

Barrera-Pulido²,

Gómez-Cía³

et al. 2013

Med Oral

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“…Therefore, an experienced nurse must care for the patient during each shift (17)(18)(19)(20)(21)(22). Literature studies commonly report hypovolemia due to massive intraoperative bleeding, tachycardia, and hypertension after face transplantation surgeries (10,(23)(24)(25)(26)(27).…”

Section: Hemodynamic Stabilizationmentioning

confidence: 99%

Nursing Care for Patient Who Underwent Face Transplant During Intensive Care: A Case Report

Kol¹,

İlaslan²,

Aslan³

et al. 2018

tybd

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ÖZ Literatürde yüz nakli yapılan hastanın hemşirelik bakımı ve izlemine yönelik bilgi oldukça kısıtlıdır. Yüz nakli sonrası hastanın takibi ve rahatlamasına yönelik hemşirelik girişimleri ve ilaç yönetimindeki hemşirenin sorumluluklarının tartışılması hastanın iyileşme sürecine önemli katkılar sağlayacaktır. Bu olgu yüz nakli olan hastanın cerrahi sonrası yoğun bakım sürecindeki hemşirelik bakımını kapsar. Yirmi altı yaşındaki erkek hastaya kulak ve saçlı deriyi de kapsayan total yüz nakli yapıldı. Hasta operasyon sonrası yoğun bakım sürecinde; hemodinamik denge, ağrı yönetimi, enfeksiyon kontrolü ve doku canlılığının korunması amacı ile yakından izlendi. Yoğun bakımda 8 gün takip edilen hastada hayatı tehdit eden herhangi bir problem gelişmedi. Yüz nakli yapılan hastaların bakımında hemşireliğin önemi inkar edilemez. Özellikle yoğun bakım sürecinde; ağrı ve ajitasyon kontrolü için hemşirenin varlığını hissettirmesi, ani değişen hemodinamik duruma göre ilaç yönetimi, enfeksiyon kontrolüne yönelik hasta ve çevre güvenliğinin sürdürülmesi hemşirenin sorumluluğunda olan ve hastanın iyileşmesine önemli katkı sağlayan girişimlerdir. Ancak böylesine önemli bir sorumluluk için uygun hemşirelik bakımı konusunda literatür oldukça kısıtlıdır. Bu olgu raporunun yüz nakli yapılan hasta bakımında hemşireler için aydınlatıcı olacağı düşünülmektedir.

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“…[39][40][41] A significant blood loss has been described during the procedure requiring transfusions. [42] The restoration of the circulation allograft is achieved with relatively few vascular anastomoses. Most anastomosis was performed in large diameter vessels to minimize the risk of thrombosis.…”

Section: Overall Aspects On Surgerymentioning

confidence: 99%

Current role in facial allograft transplantation: what have we learned?

Infante-Cossio¹,

Barrera-Pulido²,

Gómez-Cía³

et al. 2016

PAR

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Face transplant (FT) has evolved enormously in the last 10 years since the successful completion of the first facial transplant. This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces. The authors review the literature and discuss the main surgical, immunological, and ethical aspects as well as the results described in patients undergoing FT. To date there have been more than thirty FT worldwide. The main indication was post-traumatic deformity. In all cases a standard immunosuppression was performed with three drugs, although acute rejection episodes were observed, that could be controlled with conventional immunosuppressive regimen. Overall, functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations, although long-term data are still scarce. Major complications were opportunistic infections. Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients. Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT. All these are on the basis of accurate and careful selection of wellmotivated candidates. The next challenge will be getting new immunosuppressive treatment strategies. Although clinical experience has demonstrated the FT viability, it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical, medical and ethical problems involved.

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Severe Rhabdomyolysis After Allogeneic Transplantation of Facial Structures: A Case Report

Cited by 15 publications

References 12 publications

Facial transplantation: A concise update

Facial transplantation: A concise update

Nursing Care for Patient Who Underwent Face Transplant During Intensive Care: A Case Report

Current role in facial allograft transplantation: what have we learned?

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