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Surgeons reveal face transplant details in NEJM

Article-Surgeons reveal face transplant details in NEJM

Boston — The Brigham and Women’s Hospital surgical team that performed the United States’ first full-face transplantation (FFT) in March 2011 — and completed a total of three during the year — has released research describing details of patient preparation, novel design and execution of the operation, and unique immunosuppression protocol allowing for lowest long-term maintenance drug regimen.

Published in the New England Journal of Medicine, the research includes details of the early functional outcomes and concludes that FFT is a viable option in the treatment of severe facial deformities and injuries.

Medical News Today reports that in an effort to advance the field of face transplantation, researchers document the processes involved in a successful face-transplant program, from screening candidates to the transplant procedure itself and follow-up management.

Researchers describe the rigorous screening and consent process that each patient must pass, the details of the surgeries with a focus on the multidisciplinary collaborative efforts of an entire team of clinicians, and the similarities and differences between each procedure.

The authors also explain post-transplant care, such as monitoring and adjusting immunosuppressants while methodically screening for signs of organ rejection. Researchers discuss occurrences of single episodes of rejection in two patients and describe other complications following surgery.

Medical News Today quotes lead author Bohdan Pomahac, M.D., director of BWH’s Plastic Surgery Transplantation Program and lead surgeon in the three FFT procedures, as saying, “Unlike conventional reconstruction, facial transplantation seeks to transform severely deformed features to a near-normal appearance and function that conventional reconstructive plastic surgical techniques cannot match. … Our focus moving forward continues to be on monitoring and documenting the progress of patients who have undergone FFT, and refining the use of immunosuppressants, with the hope that one day patients will eventually need to take little or none.”

In the article, the researchers wrote, “This study provides further support for the concept that full-face transplantation is able to restore functional defects and to resurface major deficits with the use of conventional immunosuppression and early glucocorticoid withdrawal. We will continue to assess functional reintegration, as measured by standardized restoration of motor and sensory function, over time.”

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