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Review
. 2012 Sep-Oct;33(5):561-76.
doi: 10.1097/BCR.0b013e318247eb06.

Face allotransplantation and burns: a review

Anna Arno  1 , J P Barret, Rachael A Harrison, Marc G Jeschke
Affiliations
Review

Face allotransplantation and burns: a review

Anna Arno et al. J Burn Care Res. 2012 Sep-Oct.

Abstract

Burns may represent one of the main indications for face allotransplantation. Severely disfigured faces featuring a devastating appearance and great functional impairments are not only seen as burn sequelae but also occur as a result of other traumatic injuries, oncological surgical resections, benign tumors (eg, neurofibromatosis), and major congenital malformations. To date, 20 human face composite tissue allotransplants have been performed with success. Despite the initial scepticism about its applicability, due mainly to ethical and technical reasons, the previous worldwide cases and their associated positive outcomes, including acceptable immunosuppressive regimens, excellent aesthetic and functional results, and good psychological acceptance by the recipient, enable the conclusion that face composite tissue allotransplantation has become another therapeutic strategy in the reconstructive surgical armamentarium, which bears special consideration when dealing with severely disfigured burned patients. The aim of this review is to describe the basics of face composite tissue allotransplantation and give an overview of some of the cases performed until now, with special attention paid to debating the pros and cons of its applicability in burn patients.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: None of the authors has any financial interest whatsoever in any of the drugs, treatments, techniques or instruments mentioned in this article, nor any source of funding.

Figures

Figure 4
Figure 4
FCTA after severe disfigurement from burn injury: The recipient, before the transplant. From [75[: Am J Transplant 2011, 11: 386-93. Legend: Full-thickness electrical burn affecting mainly the midface, including peri-oral and peri-orbital regions, before (A) and after (B) debridement. Outcome after reconstruction previous to FCTA, including ALT (anterolateral thigh) free flap. (Photographs used with permission of Dr. Pomahac B).
Figure 5
Figure 5
FCTA after severe disfigurement from burn injury: Results at 1 year after face allotransplantation, clinically (A) and radiologically (B). From [75[: Am J Transplant 2011, 11: 386-93. Legend : Clinical appearance and 3D CT obtained 12 months after FCTA, showing skeletal integration of transplanted donor maxillary bone. (Photographs used with permission of Dr. Pomahac B).
See this image and copyright information in PMC

References

    1. Lee WPA, Yaremchuk MJ, Pan YC, et al. Relative antigenicity of components of a vascularized limb allograft. Plast Reconstr Surg. 1991;87:401–11. - PubMed
    1. Murray JE. Organ transplantation (skin, kidney, heart) and the plastic surgeon. Plast Reconstr Surg. 1971;47:425–31. - PubMed
    1. Madani H, Hettiaratchy S, Clarke A, Butler PEM. Immunosuppression in an emerging field of plastic reconstructive surgery: composite tissue allotransplantation. J Plast Reconstr Aesthet Surg. 2008;61(3):245–9. - PubMed
    1. Petruzzo P, Kanitakis J, Badet L, et al. Long-term follow-up in composite tissue allotransplantation: In-depth study of five (hand and face) recipients. Am J Transplant. 2001;11:808–16. - PubMed
    1. Hettiaratchy S, Randolph MA, Petite F, et al. Composite tissue allotransplantation: a new era in plastic surgery? Br J Plast Surg. 2004;57(5):381–91. - PubMed

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