2025
Skin Elasticity: A Potential Surrogate Marker for Facial Allograft Skin Fibrosis—A Case Series
Stögner V, Boroumand S, Vafa A, Huelsboemer L, Kauke‐Navarro M, Formica R, Leffell D, Haykal S, Pomahac B. Skin Elasticity: A Potential Surrogate Marker for Facial Allograft Skin Fibrosis—A Case Series. Clinical Transplantation 2025, 39: e70175. PMID: 40460163, DOI: 10.1111/ctr.70175.Peer-Reviewed Original ResearchConceptsPost-transplant yearVascularized composite allotransplantationRecipient/donor ageImmunosuppressive regimensSurrogate markerSmoking statusVascularized composite allotransplantation recipientsPotential surrogate markersBilateral upper armsFace transplant recipientsSkin elasticity measurementsAllograft fibrosisChronic rejectionGraft lossTransplant recipientsBilateral cheeksCase seriesDermal fibrosisSkin changesFacial allograftDegenerative skin changesGraft changesFacial skinNet elasticityRejection burdenThe Five-Item Modified Frailty Index Predicts Adverse Surgical Outcomes in Patients Undergoing Mastectomy
Chiarella L, Huelsboemer L, Diatta F, Klimitz F, Kammien A, Kochen A, Boroumand S, Allam O, Kauke-Navarro M, Pomahac B. The Five-Item Modified Frailty Index Predicts Adverse Surgical Outcomes in Patients Undergoing Mastectomy. Annals Of Surgical Oncology 2025, 32: 4829-4837. PMID: 40342005, DOI: 10.1245/s10434-025-17105-2.Peer-Reviewed Original ResearchConceptsHigh-risk patientsMFI-5Surgical complicationsFrail patientsPredicting adverse surgical outcomesNational Surgical Quality Improvement Program dataIncreased risk of complicationsQuality Improvement Program dataMethodsThis retrospective cohort studyPredicting surgical complicationsDependent functional statusHigher body mass indexAdverse surgical outcomesOdds of complicationsRetrospective cohort studyAcute kidney failureRisk of complicationsAdult female patientsCongestive heart failurePostoperative complication riskAdjusted multivariable logistic regressionBody mass indexChronic obstructive pulmonary diseaseHigh-risk groupMultivariate logistic regressionA comparative analysis of lesional skin, sentinel flap, and mucosal biopsies in assessing acute face transplant rejection
Kauke-Navarro M, Huelsboemer L, Klimitz F, Diatta F, Knoedler L, Knoedler S, Crisler W, Brown S, Lian C, Repetto F, Clark R, Murphy G, Ko C, Pomahac B. A comparative analysis of lesional skin, sentinel flap, and mucosal biopsies in assessing acute face transplant rejection. Frontiers In Immunology 2025, 16: 1562024. PMID: 40236712, PMCID: PMC11997448, DOI: 10.3389/fimmu.2025.1562024.Peer-Reviewed Original ResearchConceptsNegative predictive valueSkin biopsiesFacial skin biopsiesMucosal biopsiesTransplant rejectionRejection eventsFlap biopsiesTransplant recipientsRejection gradeBanff classificationRejection activityLesional skinBiopsyMucosal tissuesSkin rejectionGrading systemPredictive valueFacial skinSentinel tissueMucosaRejection casesSentinelTransplantationSkinRejection patternsLeveraging Artificial Intelligence to Assess Perceived Age and Donor Facial Resemblance After Face Transplantation
Boroumand S, Gu E, Allam O, Vafa A, Huelsboemer L, Stögner V, Knoedler S, Knoedler L, Klimitz F, Kauke-Navarro M, Haykal S, Pomahac B. Leveraging Artificial Intelligence to Assess Perceived Age and Donor Facial Resemblance After Face Transplantation. Annals Of Plastic Surgery 2025, 94: 468-472. PMID: 40117511, DOI: 10.1097/sap.0000000000004334.Peer-Reviewed Original ResearchConceptsArtificial intelligenceLeverage artificial intelligenceFace transplant patientsVisual analysis softwareFacial analysis softwareSimilarity matchingPostoperative imagingTransplant patientsWilcoxon rank sum testSoftwareRank sum testPatient ageAssessment of perceived ageIntelligenceAllograft ageMatching percentageDonor ageDegree of resemblancePostoperative appearanceMann-WhitneyPatientsFacial transplantationSum testDonor's faceFace transplantation
2023
Surgical management of breast fat necrosis: Multi-institutional data analysis of early outcomes and risk factors for complications
Knoedler S, Knoedler L, Patel H, Diatta F, Camacho J, Sofo G, Perozzo F, Evans B, Mookerjee V, Ayyala H, Pomahac B, Kauke-Navarro M. Surgical management of breast fat necrosis: Multi-institutional data analysis of early outcomes and risk factors for complications. Journal Of Plastic Reconstructive & Aesthetic Surgery 2023, 88: 292-295. PMID: 38029475, DOI: 10.1016/j.bjps.2023.11.015.Peer-Reviewed Original ResearchConceptsBreast fat necrosisChronic heart failureRisk factorsAdverse eventsHeart failureFemale patientsSurgical managementFat necrosisNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramHigher wound classPostoperative adverse eventsNon-cancerous conditionsOutcomes of interestQuality Improvement ProgramMajority of casesPerioperative algorithmWound classComplication occurrenceComplication ratePostoperative outcomesSurgical complicationsMedical complicationsSurgical treatmentMultivariable analysisThe surgical patient of yesterday, today, and tomorrow—a time-trend analysis based on a cohort of 8.7 million surgical patients
Knoedler S, Matar D, Friedrich S, Knoedler L, Haug V, Hundeshagen G, Kauke-Navarro M, Kneser U, Pomahac B, Orgill D, Panayi A. The surgical patient of yesterday, today, and tomorrow—a time-trend analysis based on a cohort of 8.7 million surgical patients. International Journal Of Surgery 2023, 109: 2631-2640. PMID: 37788019, PMCID: PMC10498871, DOI: 10.1097/js9.0000000000000511.Peer-Reviewed Original ResearchConceptsSurgical patientsMedian ageMedian BMISurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseACS-NSQIP databaseImprovement Program databaseObesity class IProportion of patientsCohort of patientsPrevalence of diabetesType 2 diabetesGlobal healthcare deliveryFuture surgical careField of surgeryTime trend analysisPatient ageSurgical cohortDiabetes prevalenceProgram databaseSurgical careAmerican CollegeGeneral populationPatients
2020
Indications for and Outcomes of Endoscopic Sinus Surgery and Other Rhinologic Surgery After Facial Transplant
Haug V, Yamasaki A, Fullerton Z, Maxfield A, Pomahac B, Bergmark R, Annino D. Indications for and Outcomes of Endoscopic Sinus Surgery and Other Rhinologic Surgery After Facial Transplant. JAMA Otolaryngology - Head & Neck Surgery 2020, 146: 669-671. PMID: 32525516, PMCID: PMC7290693, DOI: 10.1001/jamaoto.2020.0774.Peer-Reviewed Original ResearchRecognizing Emotional Expression as an Outcome Measure After Face Transplant
Dorante M, Kollar B, Obed D, Haug V, Fischer S, Pomahac B. Recognizing Emotional Expression as an Outcome Measure After Face Transplant. JAMA Network Open 2020, 3: e1919247. PMID: 31940037, PMCID: PMC6991259, DOI: 10.1001/jamanetworkopen.2019.19247.Peer-Reviewed Original Research
2019
The Evolving Clinical Presentation of Acute Rejection in Facial Transplantation
Haug V, Kollar B, Obed D, Kiwanuka H, Turk M, Wo L, Tasigiorgos S, Kueckelhaus M, Riella L, Pomahac B. The Evolving Clinical Presentation of Acute Rejection in Facial Transplantation. Facial Plastic Surgery & Aesthetic Medicine 2019, 21: 278-285. PMID: 30998810, PMCID: PMC6646986, DOI: 10.1001/jamafacial.2019.0076.Peer-Reviewed Original ResearchConceptsAcute rejectionSubtherapeutic tacrolimus levelsClinical signsRejection episodesImmunosuppressive therapySubclinical rejectionTacrolimus levelsMedical recordsOdds ratioFacial transplantationDiagnostic valueSignificant associationSingle-center cohort studyLate rejection episodesProtocol skin biopsiesSecond posttransplant yearSymptoms of rejectionTacrolimus blood levelsSecond postoperative yearReliable clinical signFull facial transplantationPostoperative yearPosttransplant yearYears posttransplantationAllograft rejectionFive-Year Follow-up after Face Transplantation
Tasigiorgos S, Kollar B, Turk M, Perry B, Alhefzi M, Kiwanuka H, Nizzi M, Marty F, Chandraker A, Tullius S, Riella L, Pomahac B. Five-Year Follow-up after Face Transplantation. New England Journal Of Medicine 2019, 380: 2579-2581. PMID: 31141626, DOI: 10.1056/nejmc1810468.Peer-Reviewed Original Research
2018
Chronic rejection of human face allografts
Krezdorn N, Lian C, Wells M, Wo L, Tasigiorgos S, Xu S, Borges T, Frierson R, Stanek E, Riella L, Pomahac B, Murphy G. Chronic rejection of human face allografts. American Journal Of Transplantation 2018, 19: 1168-1177. PMID: 30312535, PMCID: PMC6433509, DOI: 10.1111/ajt.15143.Peer-Reviewed Original ResearchConceptsChronic rejectionComposite allograftsAutoimmune cutaneous disordersImmune-mediated changesLymphocyte-mediated cytotoxicityC-fosSevere facial disfigurementType IAcute rejectionSurveillance biopsiesIatrogenic immunosuppressionVascular ectasiaFollicular pluggingSystemic sclerosisHistopathologic evidenceClinical manifestationsPreventative therapyCutaneous disordersGraft durabilityFace allograftNasal mucosaPathologic changesPathologic alterationsEpidermal thinningSclerotic zoneIncreased levels of circulating MMP3 correlate with severe rejection in face transplantation
Kollar B, Shubin A, Borges T, Tasigiorgos S, Win T, Lian C, Dillon S, Gu X, Wyrobnik I, Murphy G, Pomahac B, Libermann T, Riella L. Increased levels of circulating MMP3 correlate with severe rejection in face transplantation. Scientific Reports 2018, 8: 14915. PMID: 30297859, PMCID: PMC6175842, DOI: 10.1038/s41598-018-33272-7.Peer-Reviewed Original ResearchConceptsSevere rejectionFace transplantationLarge independent patient cohortsAcute rejection episodesAnti-rejection treatmentFirst postoperative yearLongitudinal serum samplesNon-invasive candidate biomarkersViable treatment optionSOMAscan proteomics platformIndependent patient cohortsFace transplant recipientsRejection episodesPostoperative yearTransplant recipientsDevastating injuriesMMP3 levelsTransplant rejectionHistological gradePatient cohortTreatment optionsSurrogate markerMMP3 proteinCandidate biomarkersTransplantationSoftware‐based video analysis of functional outcomes of face transplantation
Fischer S, Diehm Y, Dorante M, Kotsougiani D, Kueckelhaus M, Alhefzi M, Bueno E, Pomahac B. Software‐based video analysis of functional outcomes of face transplantation. Microsurgery 2018, 39: 53-61. PMID: 30159931, DOI: 10.1002/micr.30360.Peer-Reviewed Original ResearchConceptsFace transplantationNormal populationAssessment of outcomesDifferent time pointsFunctional outcomeFacial movementsPatient's abilitySame patientTransplantationMouth openingOutcome assessmentPatientsValuable assessment toolOpen mouthEye closureTime pointsRetrospective assessmentMonthsLip purseFacial transplantationAssessment toolSound evidenceOutcomesNoseEyebrowsQuality of Life and Psychosocial Functioning 2 Years Following Facial Transplantation
Oser M, Nizzi M, Zinser J, Turk M, Epstein R, Bueno E, Gitlin D, Pomahac B. Quality of Life and Psychosocial Functioning 2 Years Following Facial Transplantation. Journal Of The Academy Of Consultation-Liaison Psychiatry 2018, 59: 591-600. PMID: 29861176, DOI: 10.1016/j.psym.2018.04.005.Peer-Reviewed Original ResearchConceptsPhysical health QoLDepressive symptomsHealth statusPhysical health-related QoLFace transplantationOverall depressive symptomsHealth-related QoLMental health QOLSubthreshold depressive symptomsSevere facial disfigurementFacial transplantationQuality of lifeImmunosuppression inductionMonths posttransplantationDepressive episodePhysical QoLHigh health statusPatientsTransplantationQoLPsychosocial functioningLife outcomesCeiling effectsFacial disfigurementSymptomsFacial restoration by transplantation
Kollar B, Pomahac B. Facial restoration by transplantation. The Surgeon 2018, 16: 245-249. PMID: 29490887, DOI: 10.1016/j.surge.2018.01.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultFacial InjuriesFacial TransplantationFemaleHumansMaleMiddle AgedPlastic Surgery ProceduresConceptsWorld War I.World War IIModern plastic surgerySir Harold GilliesPeter Bent Brigham HospitalWar IIFace transplantationFirst successful kidney transplantationJoseph MurraySuccessful kidney transplantationNobel PrizeWorldFacial restorationKidney transplantationTransplant cohortUnique patientsWomen's HospitalSkin graftsOrgan transplantationTransplantationHospitalPlastic surgeonsPlastic surgerySoldiersBattlefield
2017
Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study
Grieve B, Shapiro G, Wibbenmeyer L, Acton A, Lee A, Marino M, Jette A, Schneider J, Kazis L, Ryan C, Board L, Badger K, Cancio L, Carrougher G, Carson J, Carter D, Chang P, Deeter L, Edorf F, Fagin A, Faoro N, Faucher L, Fauerbach J, Fidler P, Foster K, Friedstat J, Gibran N, Goverman J, Harrington D, Herndon D, Hickerson W, Holavanahalli R, Houng A, Hwang J, Jeng J, Joe V, Kopari N, Kowalske K, Lee R, Levi B, Liu Y, Palmieri T, Pomahač B, Reilly D, Romanowski K, Schulz J, Sheridan R, Shupp J, Sinha I, Travis T, Wibbenmeyer L. Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study. Archives Of Physical Medicine And Rehabilitation 2017, 101: s92-s98. PMID: 29097179, PMCID: PMC9201552, DOI: 10.1016/j.apmr.2017.10.007.Peer-Reviewed Original ResearchConceptsTotal body surface areaSupport group attendanceBurn survivorsGroup attendanceLarger burn sizeSupport groupsBody surface areaCross-sectional studyLife Impact Burn Recovery Evaluation (LIBRE) StudyFuture intervention studiesCross-sectional surveyPeer support groupsBurn sizeLife Impact Burn Recovery Evaluation ProfileSocial interaction scoresExperience With Patient Referrals for Upper Extremity Transplantation at a U.S. Academic Medical Center
Kiwanuka H, Aycart M, Bueno E, Pomahac B, Talbot S. Experience With Patient Referrals for Upper Extremity Transplantation at a U.S. Academic Medical Center. The Journal Of Hand Surgery 2017, 42: 751.e1-751.e6. PMID: 28648330, DOI: 10.1016/j.jhsa.2017.05.016.Peer-Reviewed Original ResearchConceptsUpper extremity transplantationMode of referralPhysician referralExtremity transplantationDemographic dataSelf-referred individualsSTUDY/LEVELInjury-related characteristicsPopulation of patientsU.S. academic medical centersUpper extremity disabilityClinical trial outcomesFisher's exact testAcademic medical centerChi-square testCommon indicationInjury characteristicsReferral patternsPatient referralTreatment modalitiesExtremity disabilityScreening practicesInstitutional experienceImmediate exclusionLevel IVThe Effects of Lip-Closure Exercise on Lip Strength and Function Following Full Facial Transplantation: A Case Report
Perry B, Richburg B, Pomahac B, Bueno E, Green J. The Effects of Lip-Closure Exercise on Lip Strength and Function Following Full Facial Transplantation: A Case Report. American Journal Of Speech-Language Pathology 2017, 26: 682-686. PMID: 28654949, DOI: 10.1044/2017_ajslp-16-0101.Peer-Reviewed Original ResearchConceptsLip strengthFacial transplantationPatient-reported outcomesFull facial transplantationRange of motionStrength training exercisesSevere facial disfigurementPreliminary findingsExercise programAdditional researchCase reportOutcome measuresClinical measuresSingle patientMotor impairmentTransplantationClinical casesPatientsFacial disfigurementExerciseEfficacyNew optionsSpeech intelligibilityExpressionSwallowingOutcomes of Solid Organ Transplants After Simultaneous Solid Organ and Vascularized Composite Allograft Procurements
Aycart M, Alhefzi M, Sharma G, Krezdorn N, Bueno E, Talbot S, Carty M, Tullius S, Pomahac B. Outcomes of Solid Organ Transplants After Simultaneous Solid Organ and Vascularized Composite Allograft Procurements. Transplantation 2017, 101: 1381-1386. PMID: 27140518, PMCID: PMC6347371, DOI: 10.1097/tp.0000000000001262.Peer-Reviewed Original ResearchMeSH KeywordsAdultComposite Tissue AllograftsFacial TransplantationFemaleGraft SurvivalHumansMaleMiddle AgedOperative TimeOrgan TransplantationPostoperative ComplicationsRegistriesRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTissue and Organ HarvestingTissue DonorsTreatment OutcomeUnited StatesYoung AdultConceptsGraft survival ratesSolid organsSurvival rateLiver recipientsTransplant recipientsAllograft procurementSolid organ allograftsSolid organ transplantsBrain-dead donorsLong-term outcomesShort-term resultsHeart recipientsIntraoperative parametersDonor surgeryOperative durationOrgan allograftsPostoperative outcomesScientific RegistryTransplantation outcomesPopulation of subjectsCase reportOperative characteristicsUnknown causeNationwide analysisOrgan transplants
2016
A Retrospective Analysis of Secondary Revisions after Face Transplantation
Aycart M, Alhefzi M, Kueckelhaus M, Krezdorn N, Bueno E, Caterson E, Pribaz J, Pomahac B. A Retrospective Analysis of Secondary Revisions after Face Transplantation. Plastic & Reconstructive Surgery 2016, 138: 690e-701e. PMID: 27673540, DOI: 10.1097/prs.0000000000002605.Peer-Reviewed Original ResearchConceptsFree tissue transferSecondary revisionFace transplantationMedical recordsRetrospective analysisTissue transferCLINICAL QUESTION/LEVELA Retrospective AnalysisDevastating facial injuriesSkin flap lossMedian time intervalAutologous free tissue transferPatients' medical recordsLocal tissue rearrangementAcute rejectionMaintenance immunosuppressionPulse steroidsPostoperative complicationsMajor infectionSuperficial musculoaponeurotic system plicationCertain patientsOperative reportsRevision surgeryFlap lossRevision procedures
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