Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study
Facial Vascularized Composite Allotransplantation (fVCA) restores form and function for patients with severe facial disfigurements, yet multi-center outcome data remain scarce. We accessed the Organ Procurement and Transplantation Network (OPTN) database from 2008 to 2024 to identify all full- or pa...
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Frontiers Media S.A.
2025-01-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14107/full |
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| author | Leonard Knoedler Thomas Schaschinger Tobias Niederegger Gabriel Hundeshagen Gabriel Hundeshagen Adriana C. Panayi Curtis L. Cetrulo Maxime Jeljeli Elena Hofmann Max Heiland Steffen Koerdt Alexandre G. Lellouch Alexandre G. Lellouch Alexandre G. Lellouch |
| author_facet | Leonard Knoedler Thomas Schaschinger Tobias Niederegger Gabriel Hundeshagen Gabriel Hundeshagen Adriana C. Panayi Curtis L. Cetrulo Maxime Jeljeli Elena Hofmann Max Heiland Steffen Koerdt Alexandre G. Lellouch Alexandre G. Lellouch Alexandre G. Lellouch |
| author_sort | Leonard Knoedler |
| collection | DOAJ |
| description | Facial Vascularized Composite Allotransplantation (fVCA) restores form and function for patients with severe facial disfigurements, yet multi-center outcome data remain scarce. We accessed the Organ Procurement and Transplantation Network (OPTN) database from 2008 to 2024 to identify all full- or partial-face fVCA recipients, excluding patients under 18 years and those with physiologically impossible BMIs. Of 25 identified patients, 16 (64%) met inclusion criteria (69% male; mean age 43 ± 14 years). Recipients experienced a median of 5 [IQR 0.0–10] acute rejection episodes, which correlated with inotrope use during donor procurement (p = 0.033). On average, patients were hospitalized 2.4 ± 1.8 times, with arginine vasopressin (AVP) administration linked to fewer hospitalizations (p = 0.035). Seven recipients (44%) experienced complications, and extended-criteria donor (ECD) status was associated with higher complication rates (p = 0.049). These findings underscore the promise of fVCA to address complex facial defects while identifying key risk factors—particularly inotrope use and ECD status, while AVP administration may mitigate hospital stays. Further studies with larger cohorts are warranted to refine perioperative strategies, improve outcomes, and expand the clinical utility of fVCA. |
| format | Article |
| id | doaj-art-f4dd9994b38247599fd98afb95bfc9d4 |
| institution | Kabale University |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj-art-f4dd9994b38247599fd98afb95bfc9d42025-01-29T04:11:38ZengFrontiers Media S.A.Transplant International1432-22772025-01-013810.3389/ti.2025.1410714107Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN StudyLeonard Knoedler0Thomas Schaschinger1Tobias Niederegger2Gabriel Hundeshagen3Gabriel Hundeshagen4Adriana C. Panayi5Curtis L. Cetrulo6Maxime Jeljeli7Elena Hofmann8Max Heiland9Steffen Koerdt10Alexandre G. Lellouch11Alexandre G. Lellouch12Alexandre G. Lellouch13Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, GermanyDepartment of Plastic and Hand Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, GermanyDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyVascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United StatesVascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyVascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United StatesShriners Children’s Boston, Boston, MA, United StatesCedars-Sinai Medical Center, Los Angeles, CA, United StatesFacial Vascularized Composite Allotransplantation (fVCA) restores form and function for patients with severe facial disfigurements, yet multi-center outcome data remain scarce. We accessed the Organ Procurement and Transplantation Network (OPTN) database from 2008 to 2024 to identify all full- or partial-face fVCA recipients, excluding patients under 18 years and those with physiologically impossible BMIs. Of 25 identified patients, 16 (64%) met inclusion criteria (69% male; mean age 43 ± 14 years). Recipients experienced a median of 5 [IQR 0.0–10] acute rejection episodes, which correlated with inotrope use during donor procurement (p = 0.033). On average, patients were hospitalized 2.4 ± 1.8 times, with arginine vasopressin (AVP) administration linked to fewer hospitalizations (p = 0.035). Seven recipients (44%) experienced complications, and extended-criteria donor (ECD) status was associated with higher complication rates (p = 0.049). These findings underscore the promise of fVCA to address complex facial defects while identifying key risk factors—particularly inotrope use and ECD status, while AVP administration may mitigate hospital stays. Further studies with larger cohorts are warranted to refine perioperative strategies, improve outcomes, and expand the clinical utility of fVCA.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14107/fullface transplantationfacial transplantationvascularized composite allotransplantationVCAOPTN |
| spellingShingle | Leonard Knoedler Thomas Schaschinger Tobias Niederegger Gabriel Hundeshagen Gabriel Hundeshagen Adriana C. Panayi Curtis L. Cetrulo Maxime Jeljeli Elena Hofmann Max Heiland Steffen Koerdt Alexandre G. Lellouch Alexandre G. Lellouch Alexandre G. Lellouch Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study Transplant International face transplantation facial transplantation vascularized composite allotransplantation VCA OPTN |
| title | Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study |
| title_full | Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study |
| title_fullStr | Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study |
| title_full_unstemmed | Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study |
| title_short | Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study |
| title_sort | multi center outcome analysis of 16 face transplantations a retrospective optn study |
| topic | face transplantation facial transplantation vascularized composite allotransplantation VCA OPTN |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14107/full |
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