Journal of reconstructive microsurgery
-
J Reconstr Microsurg · Jan 2012
ReviewThe impact of current immunosuppression strategies in renal transplantation on the field of reconstructive transplantation.
Composite tissue allograft (CTA) transplantation, such as the clinical face and hand transplants, has now been performed in multiple centers across the world. The transplants have successfully treated complex injuries that have either failed conventional approaches or where autologous reconstruction could not restore both form and function. CTA transplantation has the potential to improve outcomes over traditional techniques. ⋯ Due to the small numbers of CTA transplants performed, any modification in the immunosuppression used will likely be based from the solid organ literature. The renal transplantation literature has served as the basis for the current selection of CTA drug regimens and in this article we review the evidence in the renal transplant literature for the selection of immunosuppressive regimens. The study then compares the regimens used in both the face and hand transplantation with those regimens currently used for renal transplantation.
-
The first clinical face allotransplantation was performed by Devauchelle et al in 2005, and currently 13 facial allotransplantations have been performed worldwide. Reports on almost half of the cases were published in the literature, focusing on technical details of facial allograft inset to the recipient face. ⋯ Based on our experience with the first case of face transplantation, we describe the sequence of facial graft procurement from the human donor and compare similarities and differences between our case and previously published cases. Furthermore, we discuss different methods of restoration of the donor face and have outlined proposed guidelines for the sequence of donor operation for facial graft procurement.