2025
Facial Subunit Transplantation: Current Concepts and Future Directions
Klimitz F, Knoedler L, Hosseini H, Brown S, Knoedler S, Walton R, Pomahac B, Kauke-Navarro M. Facial Subunit Transplantation: Current Concepts and Future Directions. Annals Of Plastic Surgery 2025, 95: 427-437. PMID: 40934121, DOI: 10.1097/sap.0000000000004476.Peer-Reviewed Original ResearchConceptsFacial Vascularized Composite AllotransplantationFacial defectsFacial subunitsAnimal modelsIsolated transplantationCadaver studyFull-face transplantationComplex facial defectsExtensive facial defectsImmunosuppressive managementGraft survivalInvasive alternativePedicled optionsPreclinical modelsPreclinical studiesHuman cadaver studyFacial arteryPatient populationReconstructive surgeryGenital disordersFunctional outcomesLocal flapsTransplantationTransplanted tissueClinical experienceExperimental Swine Models for Vascularized Composite Allotransplantation and Immunosuppression: A Systematic Review and Case Report of a Novel Heterotopic Hemifacial Swine Model
Knoedler L, Klimitz F, Huelsboemer L, Niederegger T, Schaschinger T, Knoedler S, Boroumand S, Brown S, Pomahac B, Kauke-Navarro M. Experimental Swine Models for Vascularized Composite Allotransplantation and Immunosuppression: A Systematic Review and Case Report of a Novel Heterotopic Hemifacial Swine Model. Transplant International 2025, 38: 14520. PMID: 40799314, PMCID: PMC12341719, DOI: 10.3389/ti.2025.14520.Peer-Reviewed Original ResearchConceptsVascularized Composite AllotransplantationImmunosuppressive strategiesImmunological environmentCase reportVCA modelFacial Vascularized Composite AllotransplantationSwine modelSystematic reviewMGH miniature swineMiniature swineHemiface transplantationsSerial skinImmunosuppressive regimensOral functionOrthotopic modelLifelong immunosuppressionTransplantation modelLocal drug deliveryMucosal biopsiesExperimental swine modelVascular experienceExperimental therapiesFacial allograftHeterotopic modelImmune mechanismsThe prognostic relevance of donor-specific antibodies in facial transplantation – A retrospective cohort study
Huelsboemer L, Hosseini H, Klimitz F, Diatta F, Boroumand S, O'Brien C, Parikh N, Stögner V, Formica R, Ko C, Azzi J, Draper E, Lian C, Murphy G, Pomahac B, Kauke-Navarro M. The prognostic relevance of donor-specific antibodies in facial transplantation – A retrospective cohort study. Journal Of Plastic Reconstructive & Aesthetic Surgery 2025, 103: 286-296. PMID: 40043533, DOI: 10.1016/j.bjps.2025.01.028.Peer-Reviewed Original ResearchDe novo donor-specific antibodiesDonor-specific antibodiesDonor-specific antibody positivityChronic rejectionC4d depositionGraft lossPrognostic relevanceRejection gradeGrades of acute cellular rejectionDonor-specific antibody statusOccurrence of chronic rejectionTime pointsFacial Vascularized Composite AllotransplantationAcute rejection gradeAcute cellular rejectionTissue typing laboratoriesAcute rejection eventsRetrospective cohort studyTransplant-related outcomesFace transplant patientsVascularized Composite AllotransplantationCellular rejectionTransplant patientsC4d levelsRetrospective analysisB-cell infiltration distinguishes mucosal from skin patterns of rejection in facial vascularized composite allografts
Kauke-Navarro M, Crisler W, Younis N, Khetani R, Sadigh S, Teague J, Ho Sui S, Ko C, Zhan Q, Steuart S, Treister N, Pober J, Azzi J, Clark R, Pomahac B. B-cell infiltration distinguishes mucosal from skin patterns of rejection in facial vascularized composite allografts. American Journal Of Transplantation 2025, 25: 1193-1207. PMID: 39842779, DOI: 10.1016/j.ajt.2025.01.013.Peer-Reviewed Original ResearchFacial Vascularized Composite AllotransplantationPeripheral blood mononuclear cellsB cell infiltrationB cellsMucosal rejectionRejection monitoringFacial vascularized composite allograftT cell-mediated rejectionSigns of immune activationNon-rejection biopsiesGranzyme B expressionB cell populationsInnate-like B cellsBlood mononuclear cellsVascularized Composite AllograftsVascularized Composite AllotransplantationAcute rejectionOral mucosaT cellsPattern of rejectionImmune activationMucosal biopsiesPlasma cellsSkin biopsiesMononuclear cells
2024
C-reactive protein orchestrates acute allograft rejection in vascularized composite allotransplantation via selective activation of monocyte subsets
Kiefer J, Zeller J, Schneider L, Thomé J, McFadyen J, Hoerbrand I, Lang F, Deiss E, Bogner B, Schaefer A, Chevalier N, Horner V, Kreuzaler S, Kneser U, Kauke-Navarro M, Braig D, Woollard K, Pomahac B, Peter K, Eisenhardt S. C-reactive protein orchestrates acute allograft rejection in vascularized composite allotransplantation via selective activation of monocyte subsets. Journal Of Advanced Research 2024, 72: 401-420. PMID: 38992424, PMCID: PMC12147648, DOI: 10.1016/j.jare.2024.07.007.Peer-Reviewed Original ResearchAcute allograft rejectionC-reactive proteinVascularized Composite AllotransplantationAllograft rejectionAcute rejectionAllograft survivalGraft rejectionAttenuate acute allograft rejectionPreventing acute allograft rejectionImmune responseLong-term allograft survivalFacial Vascularized Composite AllotransplantationClinical allograft rejectionReduced allograft survivalChronic allograft rejectionIntravital imagingNon-classical monocytesMarkers of inflammationAcute-phase reactantsImmune-inflammatory reactionPro-inflammatory propertiesMononuclear phagocyte systemAcute-phase responseGraft infiltrationInnate immune responseLymphadenopathy and lymph node rejection following facial vascularized composite allotransplantation
Kauke-Navarro M, Sadigh S, Lee C, Panayi A, Knoedler L, Knoedler S, Stoegner V, Huelsboemer L, Jamil A, Ko C, Lian C, Murphy G, Pomahac B. Lymphadenopathy and lymph node rejection following facial vascularized composite allotransplantation. Journal Of Plastic Reconstructive & Aesthetic Surgery 2024, 91: 268-275. PMID: 38430863, DOI: 10.1016/j.bjps.2024.02.024.Peer-Reviewed Original ResearchLymph nodesVascularized Composite AllograftsGranzyme BDonor-derived immune cellsFacial vascularized composite allograftMedian time of presentationFacial Vascularized Composite AllotransplantationImmunological processesGranzyme B expressionCytotoxic T cellsNecrotizing histiocytic lymphadenitisHead and neckRetrospective cohort studyTime of presentationStages of follow-upCoexistence of donorFace transplant patientsBilateral adenopathyIncreased histiocytesSuperficial lymph nodesVascularized Composite AllotransplantationBilateral lymphadenopathyAllograft rejectionTransplant patientsDendritic cells
2022
Cytomegalovirus-related Complications and Management in Facial Vascularized Composite Allotransplantation: An International Multicenter Retrospective Cohort Study
Kauke-Navarro M, Panayi AC, Formica R, Marty F, Parikh N, Foroutanjazi S, Safi AF, Mardini S, Razonable RR, Morelon E, Gelb B, Rodriguez E, Lassus P, Pomahac B. Cytomegalovirus-related Complications and Management in Facial Vascularized Composite Allotransplantation: An International Multicenter Retrospective Cohort Study. Transplantation 2022, 106: 2031-2043. PMID: 35389381, DOI: 10.1097/tp.0000000000004132.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyAntiviral prophylaxisCohort studyComposite allotransplantationInternational multicenter retrospective cohort studyMulticenter retrospective cohort studyCMV-related complicationsFirst year posttransplantHigh-risk transplantsMore rejection episodesHigh-risk groupFacial Vascularized Composite AllotransplantationAllograft-related complicationsVascularized Composite AllotransplantationPaucity of dataAllograft lossCMV diseaseCMV viremiaCytomegalovirus serostatusR serostatusRejection episodesCMV infectionPrompt treatmentActive surveillancePatients
2021
Donor and Recipient Matching in Facial Vascularized Composite Allotransplantation: A Closer Look at the Donor Pool
Kauke M, Haug V, Obed D, Diehm Y, Tchiloemba B, Safi AF, Pomahac B. Donor and Recipient Matching in Facial Vascularized Composite Allotransplantation: A Closer Look at the Donor Pool. Plastic & Reconstructive Surgery 2021, 148: 194-202. PMID: 34181616, DOI: 10.1097/prs.0000000000008094.Peer-Reviewed Original ResearchConceptsDonor poolHepatitis CUnited NetworkPotential donorsEpstein-Barr virus seropositivityCytomegalovirus-seropositive donorsUnderrepresented patient groupsOrgan Sharing databaseFacial Vascularized Composite AllotransplantationHigh-risk characteristicsVascularized Composite AllotransplantationActual wait timesAllotransplant patientsSeronegative patientsSeropositive donorsMost patientsAllotransplant recipientsPatient characteristicsRecipient matchingSharing databasePositive donorsPatient groupVirus seropositivityOrgan SharingOrgan donors
2020
Mucosa and Rejection in Facial Vascularized Composite Allotransplantation: A Systematic Review.
Kauke M, Safi AF, Zhegibe A, Haug V, Kollar B, Nelms L, Palmer WJ, Tchiloemba B, Lian CG, Murphy GF, Pomahac B. Mucosa and Rejection in Facial Vascularized Composite Allotransplantation: A Systematic Review. Transplantation 2020, 104: 2616-2624. PMID: 32053572, DOI: 10.1097/tp.0000000000003171.Peer-Reviewed Original ResearchConceptsMucosal rejectionSystematic reviewRejection gradeMucosal biopsiesPatient managementComposite allotransplantationDiagnosis of rejectionFunction of patientsFacial Vascularized Composite AllotransplantationMeta-Analyses (PRISMA) guidelinesMEDLINE/PubMedPreferred Reporting ItemsVascularized Composite AllotransplantationPosttransplant periodBiopsy gradeSkin rejectionMucosa biopsiesAllograft skinAnimal studiesReporting ItemsBiopsyRejection processFacial allotransplantsMucosaTarget tissues
2017
Role of Facial Vascularized Composite Allotransplantation in Burn Patients
Bharadia D, Sinha I, Pomahac B. Role of Facial Vascularized Composite Allotransplantation in Burn Patients. Clinics In Plastic Surgery 2017, 44: 857-864. PMID: 28888310, DOI: 10.1016/j.cps.2017.05.017.Peer-Reviewed Original ResearchConceptsComposite allotransplantationFacial Vascularized Composite AllotransplantationExtensive burn injuriesRisk of rejectionVascularized Composite AllotransplantationQuality of lifeLifelong regimenVCA patientsImmunosuppression medicationsPowerful reconstructive toolsBurn patientsTreatment optionsSurgical techniqueBurn injuryReconstructive surgeryPatientsReconstructive toolFace transplantationAllotransplantationImproved qualityFacial formImmunosuppressionMedicationsRegimenSurgery
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