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ASPS backs proposed rule on hand, face transplants

Arlington Heights, Ill. — The American Society of Plastic Surgeons has issued a statement that it fully supports a proposed federal rule to include vascularized composite allografts (VCA), such as faces and hands, in the national organ donation registry.

The Health Resources and Services Administration is considering having face and hand transplants fall under protocols that offer the same oversight to the processes surrounding VCA procurement that is currently provided for kidney, liver, heart and other organ donations.

The proposed federal rule would bring oversight of VCA procurement and assignation under the umbrella of the HRSA-sanctioned Organ Procurement and Transplantation Network (OPTN) and the United Network for Organ Sharing (UNOS).

The ASPS statement quotes member surgeon W.P. Andrew Lee, M.D., chairman of the department of plastic and reconstructive surgery at Johns Hopkins University School of Medicine, Baltimore, as saying, “Those of us who perform this surgery firmly believe that when you transplant a hand or face, the considerations and logistics in relation to the donor families are very much like those of the organ transplant — and quite different from the skin and bone donation because the latter are basically preserved to be put on a shelf and be used any time. A hand or a face, obviously, just like a heart, kidney or liver, cannot be without a blood supply for more than a few hours. They need to be transplanted right away.”

Unlike organ donations, tissue and bone donations are regulated by the Food and Drug Administration, leaving classification of VCAs unclear.

The ASPS sent its endorsement of the proposed rule to HRSA officials last month. The Department of Health and Human Services has set no timetable for a determination on the proposal.

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