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Technical and Immunological Aspects of Face Transplantation

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Siemionow M., Sonmez E., Klimczak A.
Polish Journal of Surgery
|
2009
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vol. 81
|
issue 1
68-74
EN
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.
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Face Transplantation: Clinical Application of the Concept

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Siemionow M., Hivelin M.
Polish Journal of Surgery
|
2008
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vol. 80
|
issue 10
571-578
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.
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