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The interest in facial transplantation led to development of many experimental models and novel immunosuppressive protocols. These studies allowed testing the immunological response to immunosuppressive protocols, and tolerance induction studies with supportive cell based therapies in composite tissues allograft transplants.In this article we present our experience with face transplantation models developed in our laboratory. We also summarize immunological responses and different immunosuppressive protocols used for tolerance induction through donor chimerism.
2
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EN
The face allotransplantation is a unique procedure, requiring a lifetime immunosuppressive therapy, and as such brings an ethical debate among medical societies and general public. The indications for this procedure have to be considered when the classic reconstructive procedures failed, and the patients are left with debilitating defects precluding them from normal social life.The transplantation protocol must be approved and registered by the institutional review board and health agencies. It is crucial that a thorough assessment of the patient for each indication will be performed by a multidisciplinary team and panel of experts in the field of plastic and reconstructive surgery, maxillo facial surgery, immunology of transplantations and psychiatry. The thorough psychiatric and psychological evaluation of potential candidates is mandatory, as well as evaluation by ethic experts.Numerous experimental models and extensive anatomical studies in cadaver model lead to the clinical success of face transplantation, raising a complex ethical question despite the fact that it is an important progress in plastic and reconstructive surgery.Three face transplantations have been performed since 2005. The transplants differed and were tailored, to match the extend of each patient facial defect.In this article we present the clinical cases of face transplantation based on our experience and dissections studies and a literature review.
3
80%
EN
Food allergy is a disease with a risk of anaphylactic reactions, including death, with an increasing incidence. New methods of treatment and prevention are constantly being studied. Such hopes are created by the induction of tolerance, which is a process that is disturbed in patients with food allergy. In the first part of the article, methods of tolerance induction in primary food allergy prevention are discussed, such as exposure to allergens, breastfeeding, the importance of dietary factors and microbiome. The second part discusses the importance of immunotherapy in the induction of tolerance in patients with already developed food allergy and compared it to standard treatment method, which is the elimination diet. The reader will find information about methods, indications, contraindications, pathomechanism, effectiveness, safety and a new methods of desensitization
PL
Alergia pokarmowa to choroba obarczona ryzykiem wystąpienia reakcji anafilaktycznych, łącznie ze zgonem, o narastającej częstości występowania. Stale poszukuje się nowych metod jej leczenia i prewencji. Takie nadzieje stwarza indukcja tolerancji, czyli procesu, który ulega zaburzeniu w jej przebiegu. W pierwszej części artykułu omówione są metody indukcji tolerancji w prewencji pierwotnej alergii pokarmowej, takie jak: ekspozycja na alergeny, karmienie piersią, znaczenie składników dietetycznych i mikrobiomu. W drugiej części omówiono znaczenie immunoterapii w indukcji tolerancji u pacjentów z już rozwiniętą alergią pokarmową i porównano ją do standardowych metod leczenia, jaką jest dieta eliminacyjna. Czytelnik znajdzie tu informacje na temat metod, wskazań, przeciwwskazań, patomechanizmu, skuteczności, bezpieczeństwa oraz nowych metod odczulania.
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