Skip to main content

Five-year outcomes for face transplant recipients

Brigham surgical teams have performed face transplants for people who have suffered from severe facial injuries. The surgery holds the promise of improving physical and mental health for patients who have been severely disfigured and have no other treatment options. Today, in the New England Journal of Medicine, a Brigham team presents the longer-term outcomes for six patients who had been followed for up to 5 years after surgery, representing the largest cohort of patients in the U.S. Overall, patients had a robust return of motor and sensory function of their face, and all but one patient reported improvements in quality of life.
"From the data, you can see the clear benefits that our patients have obtained. It is important to keep in mind that there are no functional prosthetic options for face." said co-senior author Bo Pomahac, MD, the Roberta and Stephen R. Weiner Distinguished Chair in Surgery and director of Plastic Surgery Transplantation at the Brigham, who led teams that performed both partial and full face transplant procedures. "In our previous studies, we reported that patients can speak better, eat better, breathe better. These aspects are important as well. Here, we report that the return of motor function is in line with what you would see if you reconnected a severed nerve, and that sensory function appears to improve to near normal. Face transplants have given these patients enough functionality to be able to socially reintegrate in a way that would not have been possible before."
The team reports that motor function improved significantly both during and after the first post-transplant year, reaching an average of 60 percent of maximal motor function at five years of follow-up. The team also found improvements in the patients' ability to distinguish between hot and cold stimuli on their skin and respond to pressure testing in the first year after surgery.
The team observed a trend toward improvement in patient-reported quality of life, while no changes were seen in depression scores. Pomahac notes that the immunosuppressant medications which patients must take after face transplantation and related complications can place a burden on patients. Investigators are pursuing new ways to improve the patients' experience and address these challenges.
"The first partial face transplant occurred in 2005, almost 50 years after the first kidney transplant was performed here at the Brigham," said co-senior author Leonardo Riella, MD, PhD, the Medical Director of the Vascularized Composite Tissue Transplant Program at the Brigham. "Therefore, it is important to realize how young the field of face transplantation really is. While we had used knowledge gained from other solid organ transplants, the face transplant is a complex structure that includes one of the most immunologically challenging tissues of all: the skin. While we have witnessed great success so far, the challenges to minimize immunosuppression toxicity and reduce rejection rates continue."
Each patient experienced between two and seven acute rejection episodes that required treatments. Immunosuppressive drugs can have metabolic side effects, but the patients did not experience new cases of diabetes mellitus, hypertension or lipid disorders post-transplant, with the exception of one patient who was diagnosed with hypertension 2.5 years after transplantation.
"We are moving beyond the point of asking whether a patient in need will survive receiving a face transplant -- we have seen that we can do this safely. We are now asking can we quantify how much our patients benefit, and what challenges do we need to work on?" said Pomahac. "This is the next phase of evolution for this work -- like any new transplantation procedure, we first ask how we can make this safe, and we next ask, how can we make this better."
Story Source:
Materials provided by Brigham and Women's Hospital. 
Note: Content may be edited

Comments

Post a Comment

Popular posts from this blog

Dark matter may be older than the Big Bang

Dark matter, which researchers believe make up about 80% of the universe's mass, is one of the most elusive mysteries in modern physics. What exactly it is and how it came to be is a mystery, but a new Johns Hopkins University study now suggests that dark matter may have existed before the Big Bang. The study, published August 7 in  Physical Review Letters , presents a new idea of how dark matter was born and how to identify it with astronomical observations. "The study revealed a new connection between particle physics and astronomy. If dark matter consists of new particles that were born before the Big Bang, they affect the way galaxies are distributed in the sky in a unique way. This connection may be used to reveal their identity and make conclusions about the times before the Big Bang too," says Tommi Tenkanen, a postdoctoral fellow in Physics and Astronomy at the Johns Hopkins University and the study's author. While not much is known about its origins,...
Post a Comment
Read more

Home births as safe as hospital births: International study suggests

A large international study led by McMaster University shows that low risk pregnant women who intend to give birth at home have no increased chance of the baby's perinatal or neonatal death compared to other low risk women who intend to give birth in a hospital. The results have been published by  The Lancet 's  EClinicalMedicine  journal. "More women in well-resourced countries are choosing birth at home, but concerns have persisted about their safety," said Eileen Hutton, professor emeritus of obstetrics and gynecology at McMaster, founding director of the McMaster Midwifery Research Centre and first author of the paper. "This research clearly demonstrates the risk is no different when the birth is intended to be at home or in hospital." The study examined the safety of place of birth by reporting on the risk of death at the time of birth or within the first four weeks, and found no clinically important or statistically different risk between home...
Post a Comment
Read more

GSAT-11 satellite to be launched from French Guiana on Dec 5th

GSAT-11 satellite to be launched from French Guiana on Dec 5th GSAT-11 would be located at 74 East and is the fore-runner in a series of advanced communications satellite with multi-spot beam antenna coverage over Indian mainland and Islands, ISRO said. GSAT-11 is the next generation “high throughput” communication satellite configured around ISRO’s I-6K Bus. (PTI/Representational). Indian space agency ISRO is scheduled to launch GSAT-11, the “heaviest” satellite built by it, on-board Ariane-5 rocket of Arianespace from French Guiana on December 5. Weighing about 5,854 kg, GSAT-11 would play a vital role in providing broadband services across the country, and also provide a platform to demonstrate new generation applications, the Indian Space Research Organisation (ISRO) said. It is the “heaviest” satellite built by ISRO, the space agency said. GSAT-11 is the next generation “high throughput” communication satellite configured around ISRO’s  I-6K Bus, and it...
Post a Comment
Read more