The past the present and the future of face transplantation

Abstract

Face transplantation represents vascularized composite allotransplantation (VCA) organ and became one of the most rewarding reconstructive options for severely disfigured patients. This review summarizes the past, current and future challenges of face transplantation, based on our experience and literature reports. In 2005, first partial face transplantation was reported by French team. In 2008, we have performed the US first near-total face transplantation. Currently, more than 40 face transplant cases were reported worldwide. Based on the outcomes of our three patients and the literature reports, face transplantation improved aesthetics, function and the quality of life of face transplant patients. However, there are still many challenges encountered including the side effects of immunosuppressive protocols, the psychological and social problems as well as the financial challenges which need to be address in the near future to maintain face transplantation in the armamentarium of reconstructive surgery. Currently, feasibility of face transplantation was confirmed; however, the life-long immunosuppressive protocols bearing serious side effects are still required to prevent face rejection. Thus, for the future of face and other VCA, novel approaches of cell-based therapies or engineered scaffolds should be developed to make face transplantation safer.