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Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

Current role in facial allograft

transplantation: what have we learned?

Pedro Infante-Cossio , Fernando Barrera-Pulido , Tomas Gomez-Cia , Domingo
2
2
1
Sicilia-Castro , Alberto Garcia-Perla-Garcia , Purificacion Gacto-Sanchez , Jose-
2
1
2
Maria Hernandez-Guisado , Araceli Lagares-Borrego , Rocio Narros-Gimenez ,
2
2
1
Juan-David Gonzalez-Padilla 1
1 Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, 41013 Seville, Spain.
2 Department of Plastic and Reconstructive Surgery, Virgen del Rocio University Hospital, 41013 Seville, Spain.
Address for correspondence: Dr. Pedro Infante-Cossio, Department of Oral and Maxillofacial Surgery, Virgen del Rocio University
Hospital, Av. Manuel Siurot, 41013 Seville, Spain. E-mail: pinfante@us.es
Dr. Pedro Infante-Cossio, M.D., D.D.S., Ph.D., received both his medical and dental degree from the University of
Seville, Spain. He obtained his PhD degree and received his Oral and Maxillofacial Surgery training at the Virgen del
Rocio University Hospital, Seville, Spain. From 1994 he has been consultant in Oral and Maxillofacial Surgery at the
Virgen del Rocio University Hospital, Seville, Spain. Currently, he is Full Professor in Oral and Maxillofacial Surgery
at the Faculty of Medicine and Dentistry in Seville, Spain.

ABSTRACT
Face transplant (FT) has evolved enormously in the last 10 years since the successful completion
of the first facial transplant. This procedure has become a new reconstructive option for complex
facial deformities to restore the anatomy of patients with severely disfigured faces. The authors
review the literature and discuss the main surgical, immunological, and ethical aspects as
well as the results described in patients undergoing FT. To date there have been more than
thirty FT worldwide. The main indication was post-traumatic deformity. In all cases a standard
immunosuppression was performed with three drugs, although acute rejection episodes were
observed, that could be controlled with conventional immunosuppressive regimen. Overall,
functional and aesthetic results have been excellent at short-term and high satisfaction rate
exceeded initial expectations, although long-term data are still scarce. Major complications were
opportunistic infections. Five deaths that occurred have reopened the ethical debate about the
potential complications and concerns of providing informed consent to recipients. Continuous
progresses in microsurgical techniques and preoperative planning have promoted the evolution
from partial to full FT. All these are on the basis of accurate and careful selection of well-
motivated candidates. The next challenge will be getting new immunosuppressive treatment
strategies. Although clinical experience has demonstrated the FT viability, it is still considered
an experimental procedure in which we have much to learn to define its true role in the current
reconstructive surgery and resolve major technical, medical and ethical problems involved.
Key words:
Face transplantation; composite tissue transplantation; facial allograft transplantation; facial
reconstruction; outcomes and complications of face transplantation

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Website:
http://www.parjournal.net How to cite this article: Infante-Cossio P, Barrera-Pulido F, Gomez-
Cia T, Sicilia-Castro D, Garcia-Perla-Garcia A, Gacto-Sanchez P,
Hernandez-Guisado JM, Lagares-Borrego A, Narros-Gimenez R,
Gonzalez-Padilla JD. Current role in facial allograft transplantation:
DOI: what have we learned? Plast Aesthet Res 2016;3:211-8.
10.20517/2347-9264.2016.11
Received: 28-03-2016; Accepted: 14-04-2016
© 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc. 211