BACKGROUND: The first human face allograft was performed in France on November 27, 2005. We report herein the clinicopathologic findings from the skin and oral mucosa of this allograft during the first eight months. METHODS: Sequential biopsies were taken from the facial skin (n = 3), oral mucosa (n = 20), and sentinel skin graft (n = 11) from day 3 to day 220 postgraft and examined (immuno)histologically, using a pathological score previously proposed for evaluation of rejection in composite tissue (hand) transplantation. RESULTS: The patient developed clinically rejection episodes at day 20 and during the eighth month postgraft, manifesting with redness and edema of the facial skin, oral mucosa, and sentinel graft skin. Pathologically, changes suggestive of rejection grades 0, I, II, and III were seen in 1, 1, 1, and 0 biopsies of facial skin, 7, 2, 1, and 1 biopsies of sentinel skin graft and 3, 5, 8, and 4 biopsies of oral mucosa, respectively. Pathological changes were generally more severe in the oral mucosa than in facial and sentinel graft skin (mean scores 1.85, 0.64, and 1, respectively). CONCLUSIONS: As it happens with other composite tissue allografts, close clinicopathologic monitoring of the skin (and oral mucosa) seems to be the most reliable way to detect rejection in the setting of human facial tissue allotransplantation. Apart from these rejection episodes, the skin and mucosa maintained a normal microscopic structure, paralleling functional recovery.
BACKGROUND: The first human face allograft was performed in France on November 27, 2005. We report herein the clinicopathologic findings from the skin and oral mucosa of this allograft during the first eight months. METHODS: Sequential biopsies were taken from the facial skin (n = 3), oral mucosa (n = 20), and sentinel skin graft (n = 11) from day 3 to day 220 postgraft and examined (immuno)histologically, using a pathological score previously proposed for evaluation of rejection in composite tissue (hand) transplantation. RESULTS: The patient developed clinically rejection episodes at day 20 and during the eighth month postgraft, manifesting with redness and edema of the facial skin, oral mucosa, and sentinel graft skin. Pathologically, changes suggestive of rejection grades 0, I, II, and III were seen in 1, 1, 1, and 0 biopsies of facial skin, 7, 2, 1, and 1 biopsies of sentinel skin graft and 3, 5, 8, and 4 biopsies of oral mucosa, respectively. Pathological changes were generally more severe in the oral mucosa than in facial and sentinel graft skin (mean scores 1.85, 0.64, and 1, respectively). CONCLUSIONS: As it happens with other composite tissue allografts, close clinicopathologic monitoring of the skin (and oral mucosa) seems to be the most reliable way to detect rejection in the setting of human facial tissue allotransplantation. Apart from these rejection episodes, the skin and mucosa maintained a normal microscopic structure, paralleling functional recovery.
Authors: Christina L Kaufman; Jean Kanitakis; Annemarie Weissenbacher; Gerald Brandacher; Mandeep R Mehra; Hatem Amer; Bettina G Zelger; Bernhard Zelger; Bohdan Pomahac; Sue McDiarmid; Linda Cendales; Emmanuel Morelon Journal: SAGE Open Med Date: 2020-07-14
Authors: Benjamin M Horner; Kelly K Ferguson; Mark A Randolph; Joel A Spencer; Alicia L Carlson; Erica L Hirsh; Charles P Lin; Peter E M Butler Journal: J Plast Reconstr Aesthet Surg Date: 2009-03-26 Impact factor: 2.740
Authors: Gert Blueschke; Alina Boico; Ayele H Negussie; Pavel Yarmolenko; Bradford J Wood; Ivan Spasojevic; Ping Fan; Detlev Erdmann; Thies Schroeder; Michael Sauerbier; Bruce Klitzman Journal: Plast Reconstr Surg Glob Open Date: 2018-07-09
Authors: Karim A Sarhane; Sami H Tuffaha; Justin M Broyles; Amir E Ibrahim; Saami Khalifian; Pablo Baltodano; Gabriel F Santiago; Mohammed Alrakan; Zuhaib Ibrahim Journal: Front Immunol Date: 2013-11-25 Impact factor: 7.561