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Human facial allotransplantation: a 2-year follow-up study

Summary Background Progress in composite tissue allotransplantation could provide a new treatment for patients with severe facial disfigurements. We did a partial facial allotransplantation in 2006, and report here the 2 year follow-up of the patient. Methods The recipient, a 30-year-old man from Ch... Full description

Journal Title: The Lancet (British edition) 2008, Vol.372 (9639), p.631-638
Main Author: Guo, Shuzhong, Prof
Other Authors: Han, Yan, Prof , Zhang, Xudong, MD , Lu, Binglun, MD , Yi, Chenggang, MD , Zhang, Hui, MD , Ma, Xianjie, Prof , Wang, Datai, MD , Yang, Li, MD , Fan, Xing, MD , Liu, Yunjing, BS , Lu, Kaihua, Prof , Li, Huiyuan, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/18722867
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recordid: cdi_proquest_miscellaneous_69459378
title: Human facial allotransplantation: a 2-year follow-up study
format: Article
creator:
  • Guo, Shuzhong, Prof
  • Han, Yan, Prof
  • Zhang, Xudong, MD
  • Lu, Binglun, MD
  • Yi, Chenggang, MD
  • Zhang, Hui, MD
  • Ma, Xianjie, Prof
  • Wang, Datai, MD
  • Yang, Li, MD
  • Fan, Xing, MD
  • Liu, Yunjing, BS
  • Lu, Kaihua, Prof
  • Li, Huiyuan, Prof
subjects:
  • Abridged Index Medicus
  • Adult
  • Anastomosis, Surgical - methods
  • Anti-Infective Agents - therapeutic use
  • China
  • Deformities
  • Ethics
  • Face
  • Facial Injuries - surgery
  • Facial Transplantation - methods
  • Follow-Up Studies
  • Graft Rejection - physiopathology
  • Hospitals
  • Humans
  • Immunosuppressive Agents - adverse effects
  • Immunosuppressive Agents - therapeutic use
  • Internal Medicine
  • Male
  • Patient Satisfaction
  • Patients
  • Sinuses
  • Skin Transplantation
  • Surgeons
  • Surgical Wound Infection - drug therapy
  • Surgical Wound Infection - microbiology
  • Tissue Transplantation - methods
  • Veins & arteries
ispartof: The Lancet (British edition), 2008, Vol.372 (9639), p.631-638
description: Summary Background Progress in composite tissue allotransplantation could provide a new treatment for patients with severe facial disfigurements. We did a partial facial allotransplantation in 2006, and report here the 2 year follow-up of the patient. Methods The recipient, a 30-year-old man from China, had his face severely injured by a bear in October, 2004. Allograft composite tissue transplantation was done in April, 2006, after careful systemic preparation. The surgery included anastomosis of the right mandibular artery and anterior facial vein, whole repair of total nose, upper lip, parotid gland, front wall of the maxillary sinus, part of the infraorbital wall, and zygomatic bone. Facial nerve anastomosis was done during the surgery. Quadruple immunomodulatory therapy was used, containing tacrolimus, mycophenolate mofetil, corticosteroids, and humanised IL-2 receptor monoclonal antibody. Follow-up included T lymphocyte subgroups in peripheral blood, pathological and immunohistochemical examinations, functional progress, and psychological support. Findings Composite tissue flap survived well. There were three acute rejection episodes at 3, 5, and 17 months after transplantation, but these were controlled by adjustment of the tacrolimus dose or the application of methylprednisolone pulse therapy. Hepatic and renal functions were normal, and there was no infection. The patient developed hyperglycaemia on day 3 after transplantation, which was controlled by medication. Interpretation Facial transplantation could be successful in the short term, but the procedure was not without complications. However, promising results could mean that this procedure might be an option for long-term restoration of severe facial disfigurement. Funding New Clinical Technique Foundation of Xijing Hospital.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleHuman facial allotransplantation: a 2-year follow-up study
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creatorGuo, Shuzhong, Prof ; Han, Yan, Prof ; Zhang, Xudong, MD ; Lu, Binglun, MD ; Yi, Chenggang, MD ; Zhang, Hui, MD ; Ma, Xianjie, Prof ; Wang, Datai, MD ; Yang, Li, MD ; Fan, Xing, MD ; Liu, Yunjing, BS ; Lu, Kaihua, Prof ; Li, Huiyuan, Prof
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descriptionSummary Background Progress in composite tissue allotransplantation could provide a new treatment for patients with severe facial disfigurements. We did a partial facial allotransplantation in 2006, and report here the 2 year follow-up of the patient. Methods The recipient, a 30-year-old man from China, had his face severely injured by a bear in October, 2004. Allograft composite tissue transplantation was done in April, 2006, after careful systemic preparation. The surgery included anastomosis of the right mandibular artery and anterior facial vein, whole repair of total nose, upper lip, parotid gland, front wall of the maxillary sinus, part of the infraorbital wall, and zygomatic bone. Facial nerve anastomosis was done during the surgery. Quadruple immunomodulatory therapy was used, containing tacrolimus, mycophenolate mofetil, corticosteroids, and humanised IL-2 receptor monoclonal antibody. Follow-up included T lymphocyte subgroups in peripheral blood, pathological and immunohistochemical examinations, functional progress, and psychological support. Findings Composite tissue flap survived well. There were three acute rejection episodes at 3, 5, and 17 months after transplantation, but these were controlled by adjustment of the tacrolimus dose or the application of methylprednisolone pulse therapy. Hepatic and renal functions were normal, and there was no infection. The patient developed hyperglycaemia on day 3 after transplantation, which was controlled by medication. Interpretation Facial transplantation could be successful in the short term, but the procedure was not without complications. However, promising results could mean that this procedure might be an option for long-term restoration of severe facial disfigurement. Funding New Clinical Technique Foundation of Xijing Hospital.
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subjectAbridged Index Medicus ; Adult ; Anastomosis, Surgical - methods ; Anti-Infective Agents - therapeutic use ; China ; Deformities ; Ethics ; Face ; Facial Injuries - surgery ; Facial Transplantation - methods ; Follow-Up Studies ; Graft Rejection - physiopathology ; Hospitals ; Humans ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - therapeutic use ; Internal Medicine ; Male ; Patient Satisfaction ; Patients ; Sinuses ; Skin Transplantation ; Surgeons ; Surgical Wound Infection - drug therapy ; Surgical Wound Infection - microbiology ; Tissue Transplantation - methods ; Veins & arteries
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descriptionSummary Background Progress in composite tissue allotransplantation could provide a new treatment for patients with severe facial disfigurements. We did a partial facial allotransplantation in 2006, and report here the 2 year follow-up of the patient. Methods The recipient, a 30-year-old man from China, had his face severely injured by a bear in October, 2004. Allograft composite tissue transplantation was done in April, 2006, after careful systemic preparation. The surgery included anastomosis of the right mandibular artery and anterior facial vein, whole repair of total nose, upper lip, parotid gland, front wall of the maxillary sinus, part of the infraorbital wall, and zygomatic bone. Facial nerve anastomosis was done during the surgery. Quadruple immunomodulatory therapy was used, containing tacrolimus, mycophenolate mofetil, corticosteroids, and humanised IL-2 receptor monoclonal antibody. Follow-up included T lymphocyte subgroups in peripheral blood, pathological and immunohistochemical examinations, functional progress, and psychological support. Findings Composite tissue flap survived well. There were three acute rejection episodes at 3, 5, and 17 months after transplantation, but these were controlled by adjustment of the tacrolimus dose or the application of methylprednisolone pulse therapy. Hepatic and renal functions were normal, and there was no infection. The patient developed hyperglycaemia on day 3 after transplantation, which was controlled by medication. Interpretation Facial transplantation could be successful in the short term, but the procedure was not without complications. However, promising results could mean that this procedure might be an option for long-term restoration of severe facial disfigurement. Funding New Clinical Technique Foundation of Xijing Hospital.
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titleHuman facial allotransplantation: a 2-year follow-up study
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abstractSummary Background Progress in composite tissue allotransplantation could provide a new treatment for patients with severe facial disfigurements. We did a partial facial allotransplantation in 2006, and report here the 2 year follow-up of the patient. Methods The recipient, a 30-year-old man from China, had his face severely injured by a bear in October, 2004. Allograft composite tissue transplantation was done in April, 2006, after careful systemic preparation. The surgery included anastomosis of the right mandibular artery and anterior facial vein, whole repair of total nose, upper lip, parotid gland, front wall of the maxillary sinus, part of the infraorbital wall, and zygomatic bone. Facial nerve anastomosis was done during the surgery. Quadruple immunomodulatory therapy was used, containing tacrolimus, mycophenolate mofetil, corticosteroids, and humanised IL-2 receptor monoclonal antibody. Follow-up included T lymphocyte subgroups in peripheral blood, pathological and immunohistochemical examinations, functional progress, and psychological support. Findings Composite tissue flap survived well. There were three acute rejection episodes at 3, 5, and 17 months after transplantation, but these were controlled by adjustment of the tacrolimus dose or the application of methylprednisolone pulse therapy. Hepatic and renal functions were normal, and there was no infection. The patient developed hyperglycaemia on day 3 after transplantation, which was controlled by medication. Interpretation Facial transplantation could be successful in the short term, but the procedure was not without complications. However, promising results could mean that this procedure might be an option for long-term restoration of severe facial disfigurement. Funding New Clinical Technique Foundation of Xijing Hospital.
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