Infections in Limbs, Integuments, and Face Transplantation

Abstract

Both facial and upper extremity composite tissue allotransplants consist of heterogeneous tissues including skin, muscle, bone, fat, nerves, and lymph nodes. These tissues are extremely antigenic and necessitate an immunosuppressive regimen similar to that of solid organ transplants. Thus, the patient with a face or limb transplant has many of the same infection risks in individuals following kidney transplantation such as nosocomial and opportunistic bacterial, viral, fungal, and protozoan infections. However, due to the exposed anatomy, possibility for mucosal exposure, and differing donor microflora, recipients of face or limb transplant are also susceptible to invasive diseases due to several different types of microbes. Here we present a comprehensive review of infections frequently encountered in patients undergoing solid organ transplantation with special attention to the brief experience in the prophylaxis and treatment of infection following composite tissue allotransplantation.