Previous data on the immunosuppression risks involved in facial transplantation were misleading, according to Rita Alloway, PharmD, and Steve Woodle, MD, of the University of Cincinnati (UC), and a University of Louisville team led by John Barker, MD, PhD. Their findings appear in the September edition of the journal Plastic and Reconstructive Surgery.
The first recorded facial transplant was performed in France in 2005 on a 38-year-old woman whose nose, lips and chin had been bitten off by a dog. Tissues, muscles, arteries and veins were taken from a brain-dead donor and successfully transplanted to the patient’s lower face.
There have been only two similar attempts since.
In 2004, the British Royal College of Surgeons published a controversial report predicting a high incidence of immunological complications for facial transplants. This data became a benchmark for facial transplant teams and review boards and greatly influenced the facial transplantation debate.
According to Woodle, however, the report did not provide the best risk assessment.
”In estimating the risks of immunosuppression for face transplant recipients, the biggest problem is comparing apples to oranges,” Woodle says. “What we have tried to do is to address the apples and oranges problem by a comprehensive and up-to-date consideration of the issue.”
Both the health status of solid organ transplant recipients and the tissue composition of the solid organs reported in the earlier studies are very different from that of face transplant recipients and their facial tissues, he says.
In the current study, the Cincinnati and Louisville researchers compared the 2004 data with that taken from clinical studies describing kidney and hand transplants using the latest immunosuppression techniques.
They found the outcomes to be very different from those in the 2004 study.
Based on kidney and hand transplantation cases, in which the same drug regimen was used, researchers found that acute, or immediate, rejection may occur in 10 to 70 percent of patients. In of all these cases, however, rejection was reversible by adjusting the immunosuppression medications.
They also found that fewer than 10 percent of patients would experience chronic rejection over five years.
“In considering the most recent and relevant data, we came to the conclusion that the expectations for face transplant recipients should be significantly better than those previously published,” Woodle says.
Coauthor Barker says that the lack of comparable “apples-to-apples” risk data in the field has led to debate over the ethics of face transplantation, which was the inspiration for Cincinnati-Louisville study.
“This risk-benefit equation is at the center of controversy over facial transplantation,” he says. “Physicians and scientists question whether the risks of life-long immunosuppression for patients justify the benefits of this new treatment.”
Cincinnati coauthor Alloway says that physicians often don’t realize how much patients will endure to gain relief.
“Surveys from transplant professionals have shown that doctors underestimate what people will do for a cure,” Alloway says. “Often, living disfigured is worse than risk associated with this sort of operation and the immunosuppressive risks that accompany it.”
Researchers hope this study will provide a solid foundation for future work with facial transplantation.
“We’re trying to meld the fields of transplantation and immunosuppression to produce maximum expertise on the subject,” Alloway continued. “We’re hoping to decrease toxicity and create a more manageable risk spectrum for surgeons and patients.”
Other coauthors on the study were Allen Furr, PhD, Joseph Banis, Jr., MD, Rachael Ashcroft, and Dalidor Vasilic, MD, from the University of Louisville as well as and Moshe Kon, MD, PhD, from the University of Utrecht, Netherlands.
Katie Pence | EurekAlert!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy