Facial transplantation as an option in reconstructive surgery: no mountains too high?

Abstract

Human facial allotransplantation (FA) is a testament to the impressive progress, which was and is still happening in the field of transplantation medicine and reconstructive surgery. Like every pioneering treatment option, FA faces both the clinicians' and public opinion with a huge amount of medical and psychosocial dilemmas, which, in order to introduce FA as a scientifically and socially accepted procedure into clinical practice, need to be discussed, answered and solved. This review is based on a detailed literature research in all relevant databases (MEDLINE, PubMed, Cochrane Library, specialist textbooks), however, recent papers (published between 2006 and 2008) were given highest priority for inclusion. In this review, two main limitations associated with facial tissue allotransplantation, that is, shortage of donations and life-long need for immunosuppressive treatment, are discussed and presented in both psychosocial and medical terms. Although both of these limitations potentially could successfully inhibit the transformation of FA from an experimental therapy to the treatment of choice for patients with severe functional facial impairment, recent literature suggest that FA will find a meaningful place in facial reconstructive surgery.