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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 5/2011

01-10-2011 | Review Article

Risk assessment and management in hand and facial tissue transplantation

Authors: J. H. Barker, F. Allen, M. Cunningham, P. S. Basappa, O. Wiggins, J. C. Banis Jr., R. R. Alloway, W. E. Steve, J. M. Frank

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2011

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Abstract

Purpose

Since hand and facial tissue transplantation are new treatments, risk data must be derived from early reports of the few cases done to date combined with extrapolations from other procedures with similar risks. This manuscript summarizes data from both sources including eight separate studies that measure the real and perceived risks associated with hand and facial tissue transplantation.

Methods

Real Risks: Several large clinical studies describing risk data from kidney transplant recipients (10-years experience) and risk data from 49 human hand transplants in 33 recipients (>10 years experience) were reviewed. Perceived Risks: Over 500 subjects with different life experiences (facially disfigured, amputees, laryngectomees, kidney transplant recipients, transplant and reconstructive surgeons, and controls) were surveyed using a standardized and validated risk assessment instrument.

Results

Real Risks: Contrary to earlier estimates the risks of acute rejection are higher (80–85%) while the risks of chronic rejection (<5%) and other complications are lower than previously reported. Perceived Risks: Despite different life experiences, those questioned would accept similar amounts of risk to receive different types of transplant procedures (hand, foot, face, larynx, and kidney) but all would accept the most risk for a facial tissue transplant. Kidney transplant recipients, who live with the risks of immunosuppression, would accept the most risk while facially disfigured individuals and reconstructive surgeons, who have real-life experience with facial disfigurement, would accept the least.

Conclusions

These studies contribute to the growing body of risk data necessary for moving hand and face transplantation into mainstream medicine.
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Metadata
Title
Risk assessment and management in hand and facial tissue transplantation
Authors
J. H. Barker
F. Allen
M. Cunningham
P. S. Basappa
O. Wiggins
J. C. Banis Jr.
R. R. Alloway
W. E. Steve
J. M. Frank
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
European Journal of Trauma and Emergency Surgery / Issue 5/2011
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-011-0131-4

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