International consensus recommendations on face transplantation: A 2-step Delphi study


Longo B., Alberti F. B., Pomahac B., Pribaz J. J., Meningaud J., Lengelé B., ...More

American Journal of Transplantation, vol.24, no.1, pp.104-114, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 24 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.1016/j.ajt.2023.08.023
  • Journal Name: American Journal of Transplantation
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, PASCAL, CAB Abstracts, EMBASE, MEDLINE, Public Affairs Index, Veterinary Science Database
  • Page Numbers: pp.104-114
  • Keywords: consensus recommendations, face transplantation, vascularized composite allotransplantation
  • Akdeniz University Affiliated: Yes

Abstract

Face transplantation is a viable reconstructive approach for severe craniofacial defects. Despite the evolution witnessed in the field, ethical aspects, clinical and psychosocial implications, public perception, and economic sustainability remain the subject of debate and unanswered questions. Furthermore, poor data reporting and sharing, the absence of standardized metrics for outcome evaluation, and the lack of consensus definitions of success and failure have hampered the development of a “transplantation culture” on a global scale. We completed a 2-round online modified Delphi process with 35 international face transplant stakeholders, including surgeons, clinicians, psychologists, psychiatrists, ethicists, policymakers, and researchers, with a representation of 10 of the 19 face transplant teams that had already performed the procedure and 73% of face transplants. Themes addressed included patient assessment and selection, indications, social support networks, clinical framework, surgical considerations, data on patient progress and outcomes, definitions of success and failure, public image and perception, and financial sustainability. The presented recommendations are the product of a shared commitment of face transplant teams to foster the development of face transplantation and are aimed at providing a gold standard of practice and policy.