Total Face, Double Jaw, and Tongue Transplantation

Dorafshar, Amir H.; Bojovic, Branko; Christy, Michael R.; Borsuk, Daniel E.; Iliff, Nicholas T.; Brown, Emile N.; Shaffer, Cynthia K.; Kelley, Tina; Kukuruga, Debra; Barth, Rolf N.; Bartlett, Stephen T.; Rodriguez, Eduardo D.

doi:10.1097/prs.0b013e3182789d38

Cited by 128 publications

(116 citation statements)

References 19 publications

Supporting

Mentioning

113

Contrasting

Order By: Relevance

“…This failure is probably a result of adjustments of the relation between the mandibular condyle and its fossa while under anaesthesia compared with conscious activity with displacement of the mandible by muscular activity. 84 Refi nements in technologies such as computer-assisted design and modelling, intraoperative navigation, and premanufactured cutting guides 18 might further improve cutting and positioning of the facial skeleton.…”

Section: Bone and Dental Occlusionmentioning

confidence: 99%

“…18,72 Functional and aesthetic restoration can be assisted through several secondary procedures, including bone and dental realignment, soft-tissue resuspension and contouring, full-thickness skin grafting, fat injection, and dermabrasion. 73,74 The goals of these revisionary procedures are to optimise functional out comes, accentuate facial features disguised by bulky tissue, ensure proper colour and texture, and match thickness across the entirety of the face.…”

Section: Post-transplantation Revisionmentioning

confidence: 99%

“…23 Antithymocyte globulin was used for induction for all but two patients, who instead received humanised anti-interleukin 2 postoperatively on days 0, 15, and 30, and alemtuzumab intraoperatively. 18,23 Steroid bolus and taper was used for all patients, progressing to lower steroid maintenance doses. Steroids were eventually withdrawn for four patients at 7 weeks, 39 8 weeks, 39 22 weeks, 23 and 51 weeks.…”

Section: Immunological Principles Immunosuppressive Strategiesmentioning

confidence: 99%

See 2 more Smart Citations

Facial transplantation: the first 9 years

et al. 2014

View full text Add to dashboard Cite

Since the fi rst facial transplantation in 2005, 28 have been done worldwide with encouraging immunological, functional, psychological, and aesthetic outcomes. Unlike solid organ transplantation, which is potentially life-saving, facial transplantation is life-changing. This diff erence has generated ethical concerns about the exposure of otherwise young and healthy individuals to the sequelae of lifelong, high-dose, multidrug immunosuppression. Nevertheless, advances in immunomodulatory and immunosuppressive protocols, microsurgical techniques, and computer-aided surgical planning have enabled broader clinical application of this procedure to patients. Although episodes of acute skin rejection continue to pose a serious threat to face transplant recipients, all cases have been controlled with conventional immunosuppressive regimens, and no cases of chronic rejection have been reported.

show abstract

Section: Bone and Dental Occlusionmentioning

confidence: 99%

Section: Post-transplantation Revisionmentioning

confidence: 99%

Section: Immunological Principles Immunosuppressive Strategiesmentioning

confidence: 99%

See 1 more Smart Citation

Facial transplantation: the first 9 years

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Aesthetic outcomes have been equally favorable, albeit to varying degrees, exceeding expectations in many cases. Beginning with the first face transplant in 2005, delicate anatomical structures like the eyelids, nasal unit, and lips have been successfully replaced, rather than reconstructed [77,78].…”

Section: Limitations Of Conventional Reconstruction For Severe Facialmentioning

confidence: 99%

Facial Disfigurement and Identity: A Review of the Literature and Implications for Facial Transplantation

2018

AMA Journal of Ethics

View full text Add to dashboard Cite

Facial disfigurement can significantly affect personal identity and access to social roles. Although conventional reconstruction can have positive effects with respect to identity, these procedures are often inadequate for more severe facial defects. In these cases, facial transplantation (FT) offers patients a viable reconstructive option. However, FT's effect on personal identity has been less well examined, and ethical questions remain regarding the psychosocial ramifications of the procedure. This article reviews the literature on the different roles of the face as well as psychological and social effects of facial disfigurement. The effects of facial reconstruction on personal identity are also reviewed with an emphasis on orthognathic, cleft, and head and neck surgery. Finally, FT is considered in this context, and future directions for research are explored.

show abstract

“…[30,90] The functional and aesthetic improvement can be supported in various secondary procedures as such as the re-alignment of the jaws, restoration of teeth, re-suspension of the soft tissues, fat injections and dermabrasion. [91][92][93][94][95] These revisions did not seem to have caused major complications or affected in any way the immunological rejection.…”

Section: Post-transplant Revisions and Refinementsmentioning

confidence: 99%

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

Infante-Cossio¹,

Barrera-Pulido²,

Gómez-Cía³

et al. 2016

PAR

View full text Add to dashboard Cite

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.

show abstract

Total Face, Double Jaw, and Tongue Transplantation

Abstract: Therapeutic, V.

Cited by 128 publications

References 19 publications

Facial transplantation: the first 9 years

Facial transplantation: the first 9 years

Facial Disfigurement and Identity: A Review of the Literature and Implications for Facial Transplantation

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

Contact Info

Product

Resources

About