Chapter 37 - Composite tissue allotransplantation

Summary

In recent years, face transplantation has become a clinical reality and in the future may become a standard procedure. Composite tissue allotransplantation (CTA) is a new developing field of modern plastic and reconstructive surgery. A series of cadaver dissections were performed in preparation for face transplantation. Using computer-based models, the face looks neither like the donor nor the recipient prior to injury, but carries more of the characteristics of the recipient skeleton than of the donor soft tissues. Imaging is required to analyze the details of the facial defect and determine necessary structures for allotransplantation. To date there have been two scalp transplants and 14 facial allotransplantation cases reported in the literature and in media. Functional MRI, electromyography studies, and volumetric analysis are objective measures of motor recovery of facial units, whereas temperature testing and Semmes-Weinstein monofilament tests are used to monitor the sensory recovery of the facial allograft.