Chinta Sachin R, Shah Alay R, Tran David L, Lee Wen-Yu, Mangiola Massimo, Gelb Bruce E, Ceradini Daniel J, Rodriguez Eduardo D
From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY.
Division of Biostatistics, New York University Langone Health, New York, NY.
Plast Reconstr Surg Glob Open. 2025 Mar 6;13(3):e6598. doi: 10.1097/GOX.0000000000006598. eCollection 2025 Mar.
In vascularized composite allotransplantation, face transplantation stands as a transformative intervention for patients with severe facial disfigurement. Monitoring of graft rejection, however, remains a critical challenge. This study aimed to investigate the role of lymphocyte subsets in the early detection and monitoring of graft rejection in face transplantation.
We conducted a retrospective chart review of 3 face transplant recipients who underwent face transplantation at our institution. Peripheral blood samples were analyzed for lymphocyte subsets at multiple time points posttransplantation. A linear mixed-effects model was used, aiming to identify any upregulation associated with episodes of graft rejection.
A statistically significant relationship was found between clinically treated episodes of rejection, ultimately confirmed by histology, and several lymphocytic subsets. CD3 and CD3CD4 cell lineages were found to be significantly upregulated during times of rejection ( = 0.0147 and = 0.0153, respectively). Furthermore, CD3CD8 and CD16CD56 cell lineages were also found to be significantly associated with rejection ( = 0.0490 and = 0.0019, respectively). Further stratification with tacrolimus as a fixed effect demonstrated that CD3, CD3CD4, and CD15CD56 cell lineages remained significantly associated with rejection ( = 0.0167, = 0.0223, and = 0.0015, respectively).
Our study demonstrates that monitoring specific lymphocyte subsets offers a promising adjunct for graft surveillance that is less invasive when compared with traditionally used punch biopsies. This approach not only enhances the precision of rejection monitoring but also improves patient comfort and compliance, thereby contributing to better long-term graft outcomes.
在血管化复合组织异体移植中，面部移植对于严重面部毁容患者而言是一种变革性的干预措施。然而，监测移植物排斥反应仍然是一项严峻的挑战。本研究旨在探讨淋巴细胞亚群在面部移植移植物排斥反应的早期检测和监测中的作用。
我们对在本机构接受面部移植的3例面部移植受者进行了回顾性病历审查。在移植后的多个时间点对外周血样本进行淋巴细胞亚群分析。使用线性混合效应模型，旨在确定与移植物排斥反应发作相关的任何上调情况。
在经组织学最终证实的临床治疗的排斥反应发作与几个淋巴细胞亚群之间发现了具有统计学意义的关系。发现CD3和CD3CD4细胞谱系在排斥反应期间显著上调（分别为P = 0.0147和P = 0.0153）。此外，还发现CD3CD8和CD16CD56细胞谱系也与排斥反应显著相关（分别为P = 0.0490和P = 0.0019）。以他克莫司作为固定效应进行进一步分层分析表明，CD3、CD3CD4和CD15CD56细胞谱系仍与排斥反应显著相关（分别为P = 0.0167、P = 0.0223和P = 0.0015）。
我们的研究表明，监测特定的淋巴细胞亚群为移植物监测提供了一种有前景的辅助手段，与传统使用的打孔活检相比，其侵入性较小。这种方法不仅提高了排斥反应监测的精度，还提高了患者的舒适度和依从性，从而有助于获得更好的长期移植物结局。
