Imma Perfetto
Cosmos science journalist
The long-term outcomes for people undergoing face transplants seem optimistic, according to an evaluation of the first 50 operations undertaken globally since 2005.
Face transplants have been used as a major reconstructive option for complex and extensive facial disfigurements since 2005. For the first time, researchers have now evaluated their long-term outcomes.
The results, they say, show an encouraging rate of transplant survival and the “learning curve” shows more recent grafts having a better survival than early ones.
Corresponding author Dr Pauliina Homsy, from the Department of Plastic Surgery, at the University of Helsinki, Finland, says a total of 50 face transplants have been performed since 2005.
“Activity has been concentrated with only 18 centres in 11 countries giving this treatment. Our study demonstrates an overall 5- and 10-year survival of face transplants at 85% and 74%, respectively.”
“The majority of patients with severe facial defects can be treated with conventional methods but there are those whose defect is too complex for it.
“The encouraging face transplant survival rate suggests that face transplantation can be a long-term reconstructive option for these patients.”
These complex surgeries involve transplanting all or part of the facial tissues from a deceased donor to restore form and function in the patient. For example, in 2023 surgeons in the US carried out the first partial face and whole eye transplant.
The team collated data on all facial transplants carried out worldwide between 2005 and September 2023. This included information on the overall survival of the face transplant graft – defined as either transplant loss or patient death – and number of acute rejection episodes per year (when transplanted tissue is rejected by the patient’s immune system within the first 3 months to 1 year).
The 50 transplants were performed on 48 patients, 39 men and 9 women, 2 of whom received a second face transplant after the first was lost. They found no correlation between age or number of rejection episodes and graft survival.
However, they say complications from chronic immunosuppression are most likely responsible for a trend of graft loss and patient deaths between 8 to 12 years posttransplant.
“Thus, future analysis of detailed cumulative data on the immunosuppression levels, in correlation with complication rates, is crucial for optimising patient outcomes,” the authors write.
“Balancing the prevention of rejection with minimizing long-term therapy complications is vital for improving the long-term success of face transplants.”
The research is published in the journal JAMA Surgery.
