Leonard David A, Gordon Chad R, Sachs David H, Cetrulo Curtis L
Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Craniofac Surg. 2012 Jan;23(1):268-71. doi: 10.1097/SCS.0b013e318241b8e0.
Fourteen face transplants have been performed worldwide since the procedure was successfully introduced in 2005. Vascularized composite tissue allotransplantation may now be considered a viable option for the repair of complex craniofacial defects, for which the results of autologus reconstruction remain suboptimal. However, the benefits must be balanced against the risks inherent in major surgery and the adverse effects of lifelong immunosuppression. In this article, we review the current practice and areas of controversy in facial vascularized composite tissue allotransplantation with particular respect to the unique immunobiology of this procedure. We also describe promising recent advances in immunotherapy and tolerance induction strategies that may soon reach clinical application.
自2005年面部移植手术成功开展以来，全球已进行了14例面部移植手术。对于复杂颅面部缺损的修复，自体组织重建效果仍欠佳，而血管化复合组织异体移植如今可被视为一种可行的选择。然而，必须将其益处与大手术固有的风险以及终身免疫抑制的不良反应相权衡。在本文中，我们回顾了面部血管化复合组织异体移植的当前实践及存在争议的领域，尤其关注该手术独特的免疫生物学特性。我们还描述了免疫治疗和诱导耐受策略方面近期取得的有前景的进展，这些进展可能很快会应用于临床。
