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A Single Institution’s Experience With Diagnosing Acute Cellular Rejection in Facial Allotransplantation

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The Know-How of Face Transplantation

Abstract

Recent advances in immunosuppression and surgical techniques have progressed to make face transplants possible. These composite tissue grafts consist of skin, subcutaneous tissue, muscle, nerve, and bone. Accurate clinical and histologic rejection surveillance is vital to preserve the function of the graft. In December 2008, the first near-total face transplant was performed. Reviewing the pathology from this case reveals that the clinical impression and skin histology showed good correlation. However, the mucosal biopsies showed histologic signs of acute cellular rejection that far exceeded that of the skin biopsies. This discrepancy made it difficult for the pathology team to decide with certainty whether these changes truly represented acute cellular rejection.

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Abbreviations

ACR:

Acute cellular rejection

CCF:

Cleveland Clinic Foundation

CMV:

Cytomegalovirus

FA:

Facial allotransplantation

H&E:

Hematoxylin & Eosin

PAS:

Periodic Acid-Schiff Stain

TUNEL:

Terminal deoxynucleotidyl transferase dUTP nick end labeling

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Correspondence to Jason S. Stratton .

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© 2011 Springer London

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Stratton, J.S., Bergfeld, W.F. (2011). A Single Institution’s Experience With Diagnosing Acute Cellular Rejection in Facial Allotransplantation. In: Siemionow, M. (eds) The Know-How of Face Transplantation. Springer, London. https://doi.org/10.1007/978-0-85729-253-7_17

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  • DOI: https://doi.org/10.1007/978-0-85729-253-7_17

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