Feasibility and Perception of Cross-sex Face Transplantation to Expand the Donor Pool.


Journal

Plastic and reconstructive surgery. Global open
ISSN: 2169-7574
Titre abrégé: Plast Reconstr Surg Glob Open
Pays: United States
ID NLM: 101622231

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 30 06 2020
accepted: 20 07 2020
entrez: 2 11 2020
pubmed: 3 11 2020
medline: 3 11 2020
Statut: epublish

Résumé

A major challenge in face transplantation (FT) is the limited donor allograft pool. This study aimed to investigate the feasibility of cross-sex FT (CSFT) for donor pool expansion by: (1) comparing craniomaxillofacial metrics following CSFT versus same-sex FT (SSFT); and (2) evaluating the public and medical professionals' perception of CSFT. Seven cadaveric FTs were performed, resulting in both CSFT and SSFT. Precision of bony and soft tissue inset was evaluated by comparing pre- versus post-operative cephalometric and anthropometric measurements. Fidelity of the FT compared to the virtual plan was assessed by imaging overlay techniques. Surveys were administered to medical professionals, medical students, and general population to evaluate opinions regarding CSFT. Five CSFTs and 2 SSFTs were performed. Comparison of recipients versus post-transplant outcomes showed that only the bigonial and medial intercanthal distances were statistically different between CSFT and SSFT ( Our study demonstrates similar anthropometric and cephalometric outcomes for CSFT and SSFT. Participants were more reticent to undergo CSFT, with increased willingness if supported by research. CSFT may represent a viable option for expansion of the donor pool in future patients prepared to undergo transplantation.

Sections du résumé

BACKGROUND BACKGROUND
A major challenge in face transplantation (FT) is the limited donor allograft pool. This study aimed to investigate the feasibility of cross-sex FT (CSFT) for donor pool expansion by: (1) comparing craniomaxillofacial metrics following CSFT versus same-sex FT (SSFT); and (2) evaluating the public and medical professionals' perception of CSFT.
METHODS METHODS
Seven cadaveric FTs were performed, resulting in both CSFT and SSFT. Precision of bony and soft tissue inset was evaluated by comparing pre- versus post-operative cephalometric and anthropometric measurements. Fidelity of the FT compared to the virtual plan was assessed by imaging overlay techniques. Surveys were administered to medical professionals, medical students, and general population to evaluate opinions regarding CSFT.
RESULTS RESULTS
Five CSFTs and 2 SSFTs were performed. Comparison of recipients versus post-transplant outcomes showed that only the bigonial and medial intercanthal distances were statistically different between CSFT and SSFT (
CONCLUSIONS CONCLUSIONS
Our study demonstrates similar anthropometric and cephalometric outcomes for CSFT and SSFT. Participants were more reticent to undergo CSFT, with increased willingness if supported by research. CSFT may represent a viable option for expansion of the donor pool in future patients prepared to undergo transplantation.

Identifiants

pubmed: 33133951
doi: 10.1097/GOX.0000000000003100
pmc: PMC7544392
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e3100

Informations de copyright

Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

Déclaration de conflit d'intérêts

Disclosure: Dr. Rodriguez has received speaker honoraria for unrelated activities from DePuy Synthes CMF and KLS Martin. All the other authors have no financial interest to declare. This work was supported by the Office of Naval Research (Grant N00014-10-1-0868), the US Department of Defense—Congressionally Directed Medical Research Programs (under Reconstructive Transplant Research Award W81XWH15-2-0036), and New York University Langone Health.

Références

Circulation. 1994 Nov;90(5 Pt 2):II78-82
pubmed: 7955289
Plast Reconstr Surg. 2016 Jun;137(6):1887-97
pubmed: 27219242
Hypertension. 1998 Jul;32(1):39-45
pubmed: 9674635
Hand Clin. 2011 Nov;27(4):433-42, viii
pubmed: 22051385
J Am Soc Nephrol. 1996 Feb;7(2):318-24
pubmed: 8785403
Kidney Int Suppl. 1995 Dec;52:S38-42
pubmed: 8587281
Dig Dis Sci. 1993 Aug;38(8):1485-8
pubmed: 8344105
Aesthet Surg J. 2019 Mar 14;39(4):NP95-NP96
pubmed: 30753277
Br J Dermatol. 2019 Jan;180(1):26-30
pubmed: 30101531
Hepatology. 1995 Dec;22(6):1754-62
pubmed: 7489985
J Plast Reconstr Aesthet Surg. 2019 Feb;72(2):173-180
pubmed: 30279107
J Craniofac Surg. 2019 Jul;30(5):1339-1346
pubmed: 31299718
Ortop Traumatol Rehabil. 2010 Jan-Feb;12(1):90-9
pubmed: 20203349
Ann Plast Surg. 2013 Oct;71(4):421-8
pubmed: 24025655
Ann Surg. 2011 Aug;254(2):252-6
pubmed: 21772126
Transplantation. 2018 Nov;102(11):1885-1890
pubmed: 29781949
Transplant Proc. 1997 Dec;29(8):3371-2
pubmed: 9414752
J Craniofac Surg. 2019 Jun;30(4):1012-1015
pubmed: 30946229
J Am Soc Nephrol. 2002 Oct;13(10):2570-6
pubmed: 12239247
Ann Transplant. 2010 Jan-Mar;15(1):53-6
pubmed: 20305319
Plast Reconstr Surg. 2015 Mar;135(3):856-66
pubmed: 25719702
Lancet. 2008 Aug 23;372(9639):631-8
pubmed: 18722867
Ann Surg. 2016 Mar;263(3):e36-9
pubmed: 26859822
Perception. 1993;22(7):829-40
pubmed: 8115240
Plast Reconstr Surg. 2016 Jul;138(1):205-19
pubmed: 27348652
Ann Surg. 2018 Aug;268(2):260-270
pubmed: 29489486
Am J Transplant. 2017 Oct;17(10):2687-2695
pubmed: 28390109
Plast Reconstr Surg. 2016 May;137(5):1569-81
pubmed: 27119930
Plast Reconstr Surg. 1987 May;79(5):701-13
pubmed: 3575517
J Womens Health (Larchmt). 2005 Sep;14(7):617-26
pubmed: 16181018
Plast Reconstr Surg. 2019 Oct;144(4):717e-718e
pubmed: 31568339
Am J Clin Dermatol. 2018 Aug;19(4):517-527
pubmed: 29352423
Clin Transpl. 1987;:351-60
pubmed: 3154434
Perception. 1988;17(4):475-81
pubmed: 3244520
Am J Transplant. 2013 May;13(5):1343-9
pubmed: 23433015
J Craniofac Surg. 2019 Jul;30(5):1352-1358
pubmed: 31299721
Laryngoscope. 2011 Feb;121(2):250-61
pubmed: 21271570
Lancet. 2008 Jul 5;372(9632):49-53
pubmed: 18603158
J Sex Med. 2014 Jan;11(1):222-9
pubmed: 24344810
Int J Surg. 2011;9(5):433-6
pubmed: 21545854
Int J Oral Maxillofac Surg. 2012 Aug;41(8):885-94
pubmed: 22682235
Plast Reconstr Surg. 2018 Jan;141(1):176-185
pubmed: 29280879
Clin Transpl. 1990;:437-46
pubmed: 2103166
Lancet. 2016 Oct 1;388(10052):1398-1407
pubmed: 27567680
Circulation. 1999 May 4;99(17):2317-22
pubmed: 10226099
Perception. 1993;22(2):131-52
pubmed: 8474840
Transplant Proc. 2011 Oct;43(8):2914-6
pubmed: 21996188
Plast Reconstr Surg. 2016 Nov;138(5):1080-1081
pubmed: 27783005
Clin Transplant. 1999 Apr;13(2):181-6
pubmed: 10202615
J Oral Maxillofac Surg. 2019 Oct;77(10):2085-2103
pubmed: 31228428
Transplantation. 1996 Dec 27;62(12):1784-7
pubmed: 8990363
J Am Soc Nephrol. 2009 Sep;20(9):2025-33
pubmed: 19541808
Transplant Proc. 2013 Jan-Feb;45(1):440-3
pubmed: 23375335
Ann Thorac Surg. 1998 Jan;65(1):88-94
pubmed: 9456101
Transplantation. 2001 Dec 27;72(12):1920-3
pubmed: 11773889
Plast Reconstr Surg. 2014 Dec;134(6):1295-304
pubmed: 25255115
Ortop Traumatol Rehabil. 2010 Nov-Dec;12(6):570-80
pubmed: 21273653
Am J Kidney Dis. 1993 May;21(5 Suppl 2):66-72
pubmed: 8494022

Auteurs

Michael Sosin (M)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Isabel S Robinson (IS)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Gustave K Diep (GK)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Allyson R Alfonso (AR)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Samantha G Maliha (SG)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Daniel J Ceradini (DJ)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Jamie P Levine (JP)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

David A Staffenberg (DA)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Pierre B Saadeh (PB)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Eduardo D Rodriguez (ED)

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Classifications MeSH