Facial allotransplantation: a 3-year follow-up report

Abstract

Introduction: Long term follow-up of face transplant patients is fundamental to our understanding of risks and benefits of this procedure. Worldwide experience has shown that function improves gradually over time.

Methods: In April of 2009, a multidisciplinary team at Brigham and Women's Hospital performed face transplantation on a male patient to address a severe facial defect caused by high-voltage burns. Physical and occupational therapy was performed for the first six post-operative months. Close monitoring of the patient's functional recovery, immunosuppression, and quality of life was performed at set time points.

Results: Three years after face transplantation, the patient has recovered near-normal sensation. Along with satisfactory aesthetic results, his motor function continues to improve, aiding his speech, facial expressions, and social interaction. Furthermore, the patient reports continued improvements in quality of life. Infectious, metabolic, and immunologic complications have been successfully managed in a team approach. Immunosuppression doses have been effectively reduced, and steroid therapy was withdrawn before the end of the first postoperative year.

Conclusions: The presented outcomes demonstrate the procedure's growing role in reconstructive surgery as teams continue to focus their efforts on further optimization of immunosuppression and surgical technique.

Keywords: Allograft; Composite tissue allotransplantation; Face transplant outcomes; Face transplantation; Vascularized composite allotransplantation.