Toure Gaoussou, Meningaud Jean-Paul, Bertrand Jacques-Charles, Hervé Christian
Department of Medical Ethics, Faculté de médecine Necker, Centre Universitaire des Saints-Pères, Paris, France.
J Oral Maxillofac Surg. 2006 May;64(5):789-93. doi: 10.1016/j.joms.2006.01.010.
Composite tissue allotransplantation has become a clinical reality and a major breakthrough in reconstructive surgery. The current boundary of dispute on composite tissue allotransplantation is regarding the full-face transplantation. The aim of this article is to provide a comprehensive overview of how facial allotransplantation has been approached in the scientific literature.
The selection of articles was conducted using PubMed at between January 2000 and September 2005. The search terms were "facial graft," "facial transplantation," and "facial allotransplant." The criteria of analysis were the category of articles and the presence of 6 items: 1) issues regarding the donor; 2) psychological impact on the recipient; 3) surgical risks; 4) immunologic risks; 5) socio-cultural aspects; and 6) expense.
Thirty-eight articles were included. The first article was published in 2002. Most articles over the last 4 years dealt with issues of medical ethics. The annual rate of basic research articles was relatively stable. Conversely, the rate of 'view points,' notably regarding ethics aspects, increased dramatically in 2004. The issues regarding the donor were found in 26% of the articles, the psychological echo on the recipient in 53% of the articles but in 81% of the medical ethics papers, the immunologic risks in 81% of the articles, the surgical risks in 66% of the articles, socio-cultural aspects in 34% of the articles, and expense problems in 5% of the articles.
Psychological, immunologic, and surgical risks are the problems addressed most in the literature. Cost, donor, social, and cultural aspects are least addressed. There is a lack of hard data in the literature regarding those problems.
复合组织异体移植已成为临床现实，是重建外科领域的一项重大突破。目前复合组织异体移植争议的焦点在于全脸移植。本文旨在全面概述科学文献中面部异体移植的研究方法。
于2000年1月至2005年9月期间使用PubMed进行文献筛选。检索词为“面部移植”“面部移植手术”和“面部异体移植”。分析标准包括文章类别以及是否存在6个项目：1）供体相关问题；2）对受者的心理影响；3）手术风险；4）免疫风险；5）社会文化方面；6）费用。
共纳入38篇文章。第一篇文章发表于2002年。过去4年中，大多数文章涉及医学伦理问题。基础研究文章的年发表率相对稳定。相反，2004年“观点”类文章，尤其是关于伦理方面的文章数量大幅增加。26%的文章涉及供体相关问题，53%的文章涉及对受者的心理影响，但在81%的医学伦理论文中涉及，81%的文章涉及免疫风险，66%的文章涉及手术风险，34%的文章涉及社会文化方面，5%的文章涉及费用问题。
心理、免疫和手术风险是文献中讨论最多的问题。费用、供体、社会和文化方面讨论最少。关于这些问题，文献中缺乏确凿的数据。
