4.8 Article

Three Patients with Full Facial Transplantation

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 366, Issue 8, Pages 715-722

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa1111432

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Funding

  1. Department of Defense under the Biomedical Translational Initiative [W911QY-09-C-0216]
  2. Brigham and Women's Hospital under the Biomedical Translational Initiative [W911QY-09-C-0216]

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Unlike conventional reconstruction, facial transplantation seeks to correct severe deformities in a single operation. We report on three patients who received full-face transplants at our institution in 2011 in operations that aimed for functional restoration by coaptation of all main available motor and sensory nerves. We enumerate the technical challenges and postoperative complications and their management, including single episodes of acute rejection in two patients. At 6 months of follow-up, all facial allografts were surviving, facial appearance and function were improved, and glucocorticoids were successfully withdrawn in all patients.

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