BACKGROUND: Since the first procedure performed in 2005, face transplantation has been debated as viable approach for the treatment of severe craniofacial defects. Despite the benefits provided, the experience in face allotransplantation has brought to light a significant risk of complications, including allograft removal or loss, and mortality. The present study is intended to provide an updated review on complications and major challenges witnessed over 18 years of experience in the field. METHODS: A systematic review of PubMed, MEDLINE, Cochrane, Google, and Google Scholar databases on face transplantation was conducted according to PRISMA guidelines up to April 2023. Articles providing details on cases of face allograft loss, removal, and patient death were included. Online articles and media reports were assessed to include information not disclosed in peer-reviewed literature. Face transplant centers were contacted to have updated follow-up information on single-face transplant cases. RESULTS: The search yielded 1006 reports, of which 28 were included. On a total of 48 procedures performed in 46 patients, adverse outcomes were gleaned in 14 cases (29%), including seven allograft losses (14.6%), and the death of ten patients (21.7%). Chronic rejection was the leading cause of allograft loss, with a median time from transplant to irreversible rejection of 90 months (IQR 88.5-102). The main causes of death were infectious complications, followed by malignancies, non-compliance to immunosuppression, and suicide. The median time to death was 48.5 months (IQR 19-122). CONCLUSIONS: To the best of our knowledge, this is the first study providing a comprehensive review of adverse outcomes in face transplantation. Considering the high rate of major complications, the heterogeneity of cases and single-center approaches, and the absence of published standards of care, the development of a consensus by face transplant teams holds the key to the field's advancement.

• MeSH
• imunologická tolerance MeSH
• imunosupresivní léčba metody   MeSH
• lidé MeSH
• rejekce štěpu MeSH
• transplantace obličeje * škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

Face transplantation is a viable reconstructive approach for severe craniofacial defects. Despite the evolution witnessed in the field, ethical aspects, clinical and psychosocial implications, public perception, and economic sustainability remain the subject of debate and unanswered questions. Furthermore, poor data reporting and sharing, the absence of standardized metrics for outcome evaluation, and the lack of consensus definitions of success and failure have hampered the development of a "transplantation culture" on a global scale. We completed a 2-round online modified Delphi process with 35 international face transplant stakeholders, including surgeons, clinicians, psychologists, psychiatrists, ethicists, policymakers, and researchers, with a representation of 10 of the 19 face transplant teams that had already performed the procedure and 73% of face transplants. Themes addressed included patient assessment and selection, indications, social support networks, clinical framework, surgical considerations, data on patient progress and outcomes, definitions of success and failure, public image and perception, and financial sustainability. The presented recommendations are the product of a shared commitment of face transplant teams to foster the development of face transplantation and are aimed at providing a gold standard of practice and policy.

• MeSH
• delfská metoda MeSH
• konsensus MeSH
• lidé MeSH
• transplantace obličeje * metody   MeSH
• vaskularizovaná kompozitní alotransplantace * MeSH
• výzkumný projekt MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Face transplantation is a viable reconstructive approach for severe craniofacial defects. Despite the evolution witnessed in the field, ethical aspects, clinical and psychosocial implications, public perception, and economic sustainability remain the subject of debate and unanswered questions. Furthermore, poor data reporting and sharing, the absence of standardized metrics for outcome evaluation, and the lack of consensus definitions of success and failure have hampered the development of a "transplantation culture" on a global scale. We completed a 2-round online modified Delphi process with 35 international face transplant stakeholders, including surgeons, clinicians, psychologists, psychiatrists, ethicists, policymakers, and researchers, with a representation of 10 of the 19 face transplant teams that had already performed the procedure and 73% of face transplants. Themes addressed included patient assessment and selection, indications, social support networks, clinical framework, surgical considerations, data on patient progress and outcomes, definitions of success and failure, public image and perception, and financial sustainability. The presented recommendations are the product of a shared commitment of face transplant teams to foster the development of face transplantation and are aimed at providing a gold standard of practice and policy.

• MeSH
• delfská metoda MeSH
• konsensus MeSH
• lidé MeSH
• transplantace obličeje * metody   MeSH
• vaskularizovaná kompozitní alotransplantace * MeSH
• výzkumný projekt MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• lékařství MeSH
• pátrací chování MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• lékařství

• MeSH
• hygiena MeSH
• mladiství MeSH
• Check Tag
• mladiství MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Hygiena. Lidské zdraví
• NLK Obory
• hygiena

• MeSH
• nefrologie metody   MeSH
• nemoci ledvin * MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• nefrologie
• NLK Publikační typ
• kolektivní monografie
• učebnice vysokých škol

Dall'autrice fantasy numero #1 e campionessa d'incassi Morgan Rice arriva il tanto atteso debutto in una serie di fantascienza. Quando SETI riceve finalmente un segnale da parte di una civiltà aliena, cosa succederà?"Una trama grandiosa, il genere di libro che farete fatica a mettere giù la sera per andare a dormire. Il finale è così mozzafiato e spettacolare da farvi venire immediatamente voglia di comprare il prossimo libro per vedere cosa succederà."-The Dallas Examiner (riguardo ad Amata) "Un'altra brillante serie che ci immerge in un fantasy fatto di onore, coraggio magia e fede nel proprio destino... Raccomandato per la libreria personale di tutti i lettori che amano i fantasy ben scritti." -Books and Movie Reviews, Roberto Mattos, riguardo a L'ascesa dei draghi"Una lettura rapida e semplice... dovrete leggere ciò che succede dopo e non vorrete metterlo giù."-FantasyOnline.net, riguardo a Un'impresa da eroiUn ragazzo di tredici anni che sta morendo per una rara malattia al cervello è l'unico in grado di udire e decifrare dei segnali che vengono dall'universo. SETI conferma che si tratta di un segnale reale.Cos'è questo messaggio? Come reagirà il mondo? E soprattutto: gli alieni stanno arrivando?"Pieno zeppo di azione .... Lo stile di Morgan Rice è forte e le premesse sono intriganti."-Publishers Weekly, riguardo a Un'impresa da eroi"Un fantasy superiore... Un libro vincente, raccomandato per chiunque ami il genere fantasy epico alimentato da giovani protagonisti potenti e credibili."-Midwest Book Review, riguardo a L'ascesa dei draghi"Un fantasy pieno zeppo di azione che sicuramente piacerà ai fan dei precedenti romanzi di Morgan Rice, come anche ai fan di opere come IL CICLO DELL'EREDITÀ di Christopher Paolini.... Gli amanti dei romanzi per ragazzi divoreranno quest'ultima opera di Morgan Rice e ne vorranno ancora."-The Wanderer, A Literary Journal (riguardo l'ascesa dei draghi)Il secondo libro della serie-L'ARRIVO-è disponibile per il pre-ordine!Sono disponibili anche le tante serie di Morgan Rice nel genere fantasy, incluse UN'IMPRESA DA EROI (LIBRO #1 DE L'ANELLO DELLO STREGONE), un libro scaricabile gratuitamente con oltre 1.300 recensioni a cinque stelle!