The Helsinki approach to face transplantation

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http://hdl.handle.net/10138/312540

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Lindford , A J , Mäkisalo , H , Jalanko , H , Lauronen , J , Anttila , V-J , Juteau , S , Ämmälä , A-J , Eskola , A , Saarni , S , Isoniemi , H , Mäkitie , A & Lassus , P 2019 , ' The Helsinki approach to face transplantation ' , Journal of Plastic, Reconstructive & Aesthetic Surgery , vol. 72 , no. 2 , pp. 173-180 . https://doi.org/10.1016/j.bjps.2018.08.030

Title: The Helsinki approach to face transplantation
Author: Lindford, Andrew J.; Mäkisalo, Heikki; Jalanko, Hannu; Lauronen, Jouni; Anttila, Veli-Jukka; Juteau, Susanna; Ämmälä, Antti-Jussi; Eskola, Anna; Saarni, Samuli; Isoniemi, Helena; Mäkitie, Antti; Lassus, Patrik
Contributor: University of Helsinki, IV kirurgian klinikka
University of Helsinki, Lastentautien yksikkö
University of Helsinki, Doctoral Programme in Clinical Research
University of Helsinki, HUSLAB
University of Helsinki, Department of Psychiatry
University of Helsinki, HUS Psychiatry
University of Helsinki, IV kirurgian klinikka
University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
University of Helsinki, Clinicum
Date: 2019-02
Language: eng
Number of pages: 8
Belongs to series: Journal of Plastic, Reconstructive & Aesthetic Surgery
ISSN: 1748-6815
URI: http://hdl.handle.net/10138/312540
Abstract: Aim: We herein describe the establishment of the Helsinki Vascularized Composite Allotransplantation (VCA) program and its execution in the first two face transplant cases. Methods & patients: The Helsinki VCA program initially required the fulfillment of legal, hospital, financial, and ethical requirements. Thereafter, the assembling of a multidisciplinary team commenced. A team of Plastic, maxillofacial and ENT surgeons comprise the facial VCA team. The protocol involves collaboration with the Solid Organ Transplant (SOT) team, transplant immunology, immunosuppression, microbiology, psychiatric evaluation, well-defined VCA indications and informed consent. Between 2011 and 2017 two patients were selected for transplantation. Both patients had a severe composite facial deformity involving the maxilla and mandible following earlier ballistic injury. Results: Patient 1 was a 35 year-old male who underwent successful near total face transplantation in February 2016 and at 30 months he has a good aesthetic outcome with symmetrical restoration of the central face and good sensory and symmetrical motor functional outcomes. Patient 2 was a 58 year-old male who underwent full face transplantation in March 2018 and at 5 months he has recovered without major problems. Conclusion: A successful facial VCA program requires a well-prepared research protocol, experts from multiple specialties and careful patient selection. The establishment of the Helsinki VCA program required long and thorough planning and resulted in the first two Nordic face transplantation cases. This protocol now forms the platform (as a proof of concept) for other types of vascularized composite allotransplantations. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Subject: Facial transplantation
Facial allotransplantation
VCA program
TERM-FOLLOW-UP
FULL-FACE
FACIAL ALLOTRANSPLANTATION
MULTIORGAN PROCUREMENT
SURGICAL ASPECTS
ALLOGRAFT
RESTORATION
REJECTION
RECONSTRUCTION
DISFIGUREMENT
3126 Surgery, anesthesiology, intensive care, radiology
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