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Face transplantation: outcomes, concerns, controversies, and future directions.
MedLine Citation:
PMID:  22337420     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Since 2005, 17 facial allotransplantations have been performed worldwide. The brief summary of current cases with ongoing concerns is presented in this article.
METHODS: Fifteen publications were reported for 10 facial allotransplantations. For the remaining 7 transplantations, information was gathered from scientific meeting presentations and media releases. The summary of current cases in terms of etiology, indications, results, complications, and outcomes are based on these data. The discussion of ongoing concerns, controversies, and overview of future implications is accomplished by reviewing the literature of ethical debates, experimental studies, clinical studies, and personal opinion.
RESULTS: Two of the 17 face transplant recipients died. Overall survival rate was 88%. No early graft loss due to technical failure was reported. All reported cases that have more than 1-year follow-up had at least 1 acute rejection episode, which was reversible with treatment. Opportunistic infections and metabolic complications were observed as adverse effects. Motor recoveries were slower than the sensorial recoveries, as expected. Functional and aesthetic outcomes were satisfactory. Concerns and controversies about concomitant face and hand transplantation, recipient blindness, recipient age, primary reconstruction option in facial trauma cases, funding, graft failure risks, and future treatment options are discussed.
CONCLUSIONS: Because of uncertainty about long-term outcomes, immunosuppression-related concerns and ethical debates limit worldwide application of facial allotransplantation. However, in selected group of patients, it is a unique reconstruction method with promising outcomes. Further research and investigation in transplant immunology and treatment hold the key to advance this treatment option.
Authors:
Maria Siemionow; Can Ozturk
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  23     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-02-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  254-9     Citation Subset:  D    
Affiliation:
From the Dermatology and Plastic Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
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