The Spanish Experience With Face Transplantation

Cavadas, Pedro C.; Landín, Luis; Ibáñez, Javier; Thioné, Alessandro; Rodrigo, Jose; Castro, Federico; Blanes, Marino; Andés, José María Zarzalejos

doi:10.1007/978-0-85729-253-7_34

Cited by 4 publications

(6 citation statements)

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“…The functional deficits are correlated with the units involved: blindness, impaired or impossible swallowing, oral eating and drinking difficulty and slurred or unintelligible pronunciation. Many patients breathe through a tracheostomy and are fed via gastro‐ or jejuno‐stomies []. Partial or total FT is considered when disfiguration affected more than two functional‐aesthetic units of the face or scalp .…”

Section: Activity and Results Of Vascularized Composite Allotransplanmentioning

confidence: 99%

Vascularized composite allotransplantation - a Council of Europe position paper

et al. 2018

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Summary After more than 120 hand‐upper extremity and 37 face transplant procedures performed worldwide, vascularized composite allotransplantation (VCA) now falls under the scope of organ transplant legislation in Europe and the United States. While in the USA, VCA has been considered as standard care since 2014, VCA in Europe is still performed through clinical research trials, except in United Kingdom. However, after two decades of favourable experience with upper extremity transplantation (UET), professionals in Europe are proposing hand allotransplantation as “controlled standard” care, as opposed to face transplantation (FT), which is still a challenging activity. The European Committee on Organ Transplantation (CD‐P‐TO) has elaborated a position paper to provide recommendations concerning regulatory aspects for UET and FT. It is aimed at Health Authorities in charge of the oversight – and coordination – of organ donation and transplantation, and at professional groups to help them manage such complex and costly programs dedicated to properly selected patients.

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Section: Activity and Results Of Vascularized Composite Allotransplanmentioning

confidence: 99%

Vascularized composite allotransplantation - a Council of Europe position paper

et al. 2018

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“…11,12 They went on to perform a FT for a HIV+ patient with a history of squamous cell carcinoma, who ultimately died 4 years later, secondary to lymphoma. [10][11][12]117 Considering the success achieved in other medical fields, exploring the feasibility of FT in HIV+ recipients was not unfounded. As a result, future discussions on HIV+ status as a recipient exclusion criterion for FT no longer depend on extrapolation from other fields of medicine.…”

Section: Discussionmentioning

confidence: 99%

“…An HIV+ status was reported by most programs as an absolute exclusion criterion because of the risks posed by the already-existing immunocompromised state of HIV+ patients 18,20,21,29,30,33–35,40,43,53,68,73,76,101,110,111 . One program did not consider it a contraindication due to recent successes with solid organ transplantation in HIV+ recipients 11,12 . They went on to perform a FT for a HIV+ patient with a history of squamous cell carcinoma, who ultimately died 4 years later, secondary to lymphoma 10–12,117 .…”

Section: Discussionmentioning

confidence: 99%

“…Appropriately, each established FT program develops their own recipient selection criteria through a multidisciplinary assessment of expert opinions and currently available evidence 7,8 . Prior experiences with FT have also shaped recipient selection guidelines, such as the death of the second face transplant recipient after noncompliance with his immunosuppressive medication regimen 9,10 and the death of a human immunodeficiency virus positive (HIV+) recipient with a history of squamous cell carcinoma who eventually succumbed to lymphoma 10–12 . Thus, understanding the impact of recipient criteria on the surgical outcomes of FT is critical to navigating future procedures.…”

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confidence: 99%

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Recipient Selection Criteria for Facial Transplantation

et al. 2022

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BackgroundRecipient selection is an important determinant of surgical outcomes in facial transplantation (FT). Appropriately, each FT program develops their own guidelines for recipient selection criteria. Currently, there is no resource to simultaneously assess and identify similarities and differences between these guidelines. Such information could be useful in distinguishing areas of FT that are well understood from those that could benefit from further exploration.MethodsWe performed a systematic review of the scientific literature from inception to June 18, 2021, using Pubmed, Embase, Cochrane Library, and Scopus to identify articles pertaining to recipient selection criteria. Clinical trials were identified through the Clinicaltrials.gov registry. United States and international program websites were reviewed for patient-facing information.ResultsOur systematic review yielded 90 suitable articles, 8 clinical trials, and 7 program websites containing the recipient selection criteria of 24 different FT programs. The most reported on recipient criteria were age, positive human immunodeficiency viral status (HIV+), positive hepatitis C viral status, psychosocial stability, and medical compliance. Other criteria were rarely addressed, such as blindness and recipient immune status.ConclusionsGuidelines among different face transplant programs are changing over time. We found consensus on certain recipient selection criteria, but the majority remain program or surgeon dependent, emphasizing that FT is still an evolving procedure. Although most programs reported on their recipient selection criteria, the rationale was often missing. Further discussion about recipient selection criteria and the reasoning behind employing or changing them will help advance the field.

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“…blindness, limb amputations), immunodeficiency state (e.g. HIV) and self induced facial disfigurement are debatable [59,61,64,65].…”

Section: Facial Allotransplantationmentioning

confidence: 99%

Evolution and Trends in Reconstructive Facial Surgery: An Update

Akadiri

2012

J. Maxillofac. Oral Surg.

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Surgical correction of congenital and acquired facial deformities has transcended the primitive era of using non biologic materials to current attempts at own face growing through biotechnology. A summative account of this trend is still lacking in the literature. The objective of this article is to present an update on current knowledge in the strides to achieve functionally and aesthetically perfect facial reconstruction. It highlights the impact of advancements in 3D imaging, stereolithographic biomodelling, microvascular surgical tissue transplantation and tissue biotechnology in the surgical efforts to solve the problems of facial disfigurement whether congenital or acquired.

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The Spanish Experience With Face Transplantation

Cited by 4 publications

References 42 publications

Vascularized composite allotransplantation - a Council of Europe position paper

Vascularized composite allotransplantation - a Council of Europe position paper

Recipient Selection Criteria for Facial Transplantation

Evolution and Trends in Reconstructive Facial Surgery: An Update

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