J Reconstr Microsurg 2012; 28(01): 35-42
DOI: 10.1055/s-0031-1272963
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Donor Operation for Face Transplantation

Maria Siemionow
1   Dermatology and Plastic Surgery Institute, Cleveland Clinic, Cleveland, Ohio
,
Can Ozturk
1   Dermatology and Plastic Surgery Institute, Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

08 October 2010

28 October 2010

Publication Date:
03 March 2011 (online)

Abstract

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. There are only few reports describing technical details of recovery of the facial allograft from the human donor. In this article, we summarize our cadaveric studies describing the methods of facial flap recovery in the cadaveric model and as well as mock facial transplantation. 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.

 
  • References

  • 1 Dubernard JM, Lengelé B, Morelon E , et al. Outcomes 18 months after the first human partial face transplantation. N Engl J Med 2007; 357: 2451-2460
  • 2 Devauchelle B, Badet L, Lengelé B , et al. First human face allograft: early report. Lancet 2006; 368: 203-209
  • 3 Guo S, Han Y, Zhang X , et al. Human facial allotransplantation: a 2-year follow-up study. Lancet 2008; 372: 631-638
  • 4 Lantieri L, Meningaud JP, Grimbert P , et al. Repair of the lower and middle parts of the face by composite tissue allotransplantation in a patient with massive plexiform neurofibroma: a 1-year follow-up study. Lancet 2008; 372: 639-645
  • 5 Siemionow MZ, Papay F, Djohan R , et al. First U.S. near-total human face transplantation: a paradigm shift for massive complex injuries. Plast Reconstr Surg 2010; 125: 111-122
  • 6 Siemionow M, Papay F, Alam D , et al. Near-total human face transplantation for a severely disfigured patient in the USA. Lancet 2009; 374: 203-209
  • 7 Pomahac B, Lengele B, Ridgway EB , et al. Vascular considerations in composite midfacial allotransplantation. Plast Reconstr Surg 2010; 125: 517-522
  • 8 Ulusal BG, Ulusal AE, Ozmen S, Zins JE, Siemionow MZ. A new composite facial and scalp transplantation model in rats. Plast Reconstr Surg 2003; 112: 1302-1311
  • 9 Nie C, Yang D, Li N, Liu G, Guo T. Establishing a new orthotopic composite hemiface/calvaria transplantation model in rabbits. Plast Reconstr Surg 2008; 122: 410-418
  • 10 Shengwu Z, Qingfeng L, Hao J , et al. Developing a canine model of composite facial/scalp allograft transplantation. Ann Plast Surg 2007; 59: 185-194
  • 11 Cendales LC, Xu H, Bacher J, Eckhaus MA, Kleiner DE, Kirk AD. Composite tissue allotransplantation: development of a preclinical model in nonhuman primates. Transplantation 2005; 80: 1447-1454
  • 12 Barth RN, Bluebond-Langner R, Nam A , et al. Facial subunit composite tissue allografts in nonhuman primates: I. Technical and immunosuppressive requirements for prolonged graft survival. Plast Reconstr Surg 2009; 123: 493-501
  • 13 Follmar KE, Baccarani A, Das RR , et al. Osteocutaneous face transplantation. J Plast Reconstr Aesthet Surg 2008; 61: 518-524
  • 14 Siemionow M, Unal S, Agaoglu G, Sari A. A cadaver study in preparation for facial allograft transplantation in humans: part I. What are alternative sources for total facial defect coverage?. Plast Reconstr Surg 2006; 117: 864-872 discussion 873–875
  • 15 Siemionow M, Agaoglu G, Unal S. A cadaver study in preparation for facial allograft transplantation in humans: part II. Mock facial transplantation. Plast Reconstr Surg 2006; 117: 876-885 discussion 886–888
  • 16 Siemionow M, Papay F, Kulahci Y , et al. Coronal-posterior approach for face/scalp flap harvesting in preparation for face transplantation. J Reconstr Microsurg 2006; 22: 399-405
  • 17 Baccarani A, Follmar KE, Baumeister SP, Marcus JR, Erdmann D, Levin LS. Technical and anatomical considerations of face harvest in face transplantation. Ann Plast Surg 2006; 57: 483-488
  • 18 Wang HY, Li QF, Zheng SW , et al. Cadaveric comparison of two facial flap-harvesting techniques for alloplastic facial transplantation. J Plast Reconstr Aesthet Surg 2007; 60: 1175-1181
  • 19 Baccarani A, Follmar KE, Das RR , et al. A pilot study in sub-SMAS face transplantation: defining donor compatibility and assessing outcomes in a cadaver model. Plast Reconstr Surg 2007; 119: 121-129
  • 20 Meningaud JP, Paraskevas A, Ingallina F, Bouhana E, Lantieri L. Face transplant graft procurement: a preclinical and clinical study. Plast Reconstr Surg 2008; 122: 1383-1389
  • 21 Alam DS, Papay F, Djohan R , et al. The technical and anatomical aspects of the World's first near-total human face and maxilla transplant. Arch Facial Plast Surg 2009; 11: 369-377
  • 22 Meningaud JP, Benjoar MD, Hivelin M, Hermeziu O, Toure G, Lantieri L. The procurement of total human face graft for allotransplantation: a preclinical study and the first clinical case. Plast Reconstr Surg 2010; June 15 (Epub ahead of print)
  • 23 Renshaw A, Chooneea T, Clarke A, Butler PE. An artificial prosthesis to reconstruct donor defects following facial transplantation. Clin Transplant 2007; 21: 574-576