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article imageMaking facial transplants easier

By Tim Sandle     Jan 21, 2014 in Health
Several facial transplants have been successfully completed. One of the on-going concerns is rejection by the recipient. Scientists have a new insight on the rejection process.
Facial transplants represent a relatively new advance in surgery. In 2009, the first face transplant was performed at Brigham and Women's Hospital (BWH) by Dr. Bohdan Pomahac. Since then the technique has undergone review and development.
A face transplant is a medical procedure to replace all or part of a person's face. The world's first full-face replant operation was on nine-year-old Sandeep Kaur, whose face was ripped off when her hair was caught in a thresher. Sandeep's mother witnessed the accident. Sandeep arrived at the hospital unconscious with her face in two pieces in a plastic bag.
The main issue is whether the transplanted face is rejected by the recipient. Following any transplant T cells (immune cells) in the recipient’s body mount an immune response to the donated tissue, threatening rejection. This process is successfully managed through immunosupression medication so that the recipient is able to tolerate the transplanted face.
In a breakthrough in this rejection process, a research team have discovered T cells involved in the rejection process are significantly of donor origin. This turns on its head (excuse the pun) the conventional theory that recipient T cells attack the donor T cells of the face.
This new insight was arrived at after the research team examined 131 face transplant biopsy specimens from a total of five patients who received a face transplant between 2009 and 2013. More studies need to be done to better understand these complex immune cell interactions; however, in the meantime, these new findings will help to develop the better diagnostic and therapeutic strategies.
The findings have been published in the journal Modern Pathology, in a paper titled “Biomarker evaluation of face transplant rejection: association of donor T cells with target cell injury.”
More about facial transplant, Surgery, Reconstruction, Faces
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