Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, USA.
Curr Opin Organ Transplant. 2020 Dec;25(6):568-575. doi: 10.1097/MOT.0000000000000812.
Face transplantation represents vascularized composite allotransplantation (VCA) organ and became one of the most rewarding reconstructive options for severely disfigured patients. This review summarizes the past, current and future challenges of face transplantation, based on our experience and literature reports.
In 2005, first partial face transplantation was reported by French team. In 2008, we have performed the US first near-total face transplantation. Currently, more than 40 face transplant cases were reported worldwide. Based on the outcomes of our three patients and the literature reports, face transplantation improved aesthetics, function and the quality of life of face transplant patients. However, there are still many challenges encountered including the side effects of immunosuppressive protocols, the psychological and social problems as well as the financial challenges which need to be address in the near future to maintain face transplantation in the armamentarium of reconstructive surgery.
Currently, feasibility of face transplantation was confirmed; however, the life-long immunosuppressive protocols bearing serious side effects are still required to prevent face rejection. Thus, for the future of face and other VCA, novel approaches of cell-based therapies or engineered scaffolds should be developed to make face transplantation safer.
面部移植代表了血管化复合组织同种异体移植（VCA）器官，成为严重毁容患者最有价值的重建选择之一。本综述基于我们的经验和文献报告，总结了面部移植过去、现在和未来的挑战。
2005 年，法国团队首次报道了部分面部移植。2008 年，我们完成了美国首例近全面部移植。目前，全球已报道了 40 多例面部移植病例。基于我们的三位患者的结果和文献报告，面部移植改善了面部移植患者的美学、功能和生活质量。然而，仍然存在许多挑战，包括免疫抑制方案的副作用、心理和社会问题以及经济挑战，这些都需要在不久的将来得到解决，以保持面部移植在重建手术中的地位。
目前，面部移植的可行性已得到证实；然而，仍需要终身使用免疫抑制方案来防止面部排斥反应，这会带来严重的副作用。因此，为了面部和其他 VCA 的未来，应该开发基于细胞的治疗方法或工程支架等新型方法，以使面部移植更安全。
