ImportanceSince 2005, a total of 50 face transplants have been reported from 18 centers in 11 countries. The overall survival of the grafts has not yet been established.ObjectiveTo assess the survival of the face transplant grafts and evaluate factors potentially influencing it.Design, Setting, and ParticipantsData on all the transplants included in this multicenter cohort study were collected at participating transplant centers for updated nonpublished data, supplemented with literature review for nonparticipating centers. Data from 2005 until September 2023, were included. Data were analyzed from November 11, 2005, through September 18, 2023. Patients included the first 50 patients in the world to have received a face transplant.ExposureFace transplant graft.Main Outcomes and MeasuresThe primary outcome was the overall survival of the face transplant graft, defined as either transplant loss or patient death. The secondary outcome was the number of acute rejection episodes per year.ResultsThe 50 transplants were performed on 39 men (81%) and 9 women (19%) with a median age of 35 (range, 19-68) years at the time of the transplant. The median follow-up time was 8.9 (range, 0.2-16.7) years. During the follow-up, 6 transplants were lost with 2 patients retransplanted. There were 10 patients who died, 2 of whom had lost a transplant. The 5- and 10-year survival of the transplants was 85% (SD, 5%) and 74% (SD, 7%), respectively. The sequential number of the transplant in the world was a significant predictor of survival (hazard ratio, 95; 95% CI, 90-100; P < 05). The median number of acute rejection episodes per year was 1.2 (range, 0-5.3) for the transplants that were lost and 0.7 (range, 0-4.6) for the transplants that survived. No correlation with patient and transplant variables was detected for either the transplant survival or the number of rejection episodes.Conclusions and RelevanceIn this study, the overall survival of the face transplants is encouraging. These data suggest that the acceptable long-term survival of face transplants makes them a reconstructive option for extensive facial defects.

中文翻译：

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全球前 50 例面部移植手术存活率的最新情况


重要性自 2005 年以来，11 个国家的 18 个中心共报告了 50 例面部移植手术。移植物的总生存期尚未确定。目的评估面部移植物的存活率并评估可能影响其的因素。设计、设置和参与者本多中心队列研究中包括的所有移植数据是在参与的移植中心收集的，以获取更新的非公开数据，并补充对非参与中心的文献综述。包括 2005 年至 2023 年 9 月的数据。数据分析时间为 2005 年 11 月 11 日至 2023 年 9 月 18 日。患者包括世界上前 50 名接受面部移植的患者。暴露面部移植物。主要结局和措施主要结局是面部移植物的总生存期，定义为移植丢失或患者死亡。次要结局是每年急性排斥反应发作的次数。结果50 例移植手术对 39 例男性 （81%） 和 9 例女性 （19%） 进行，移植时中位年龄为 35 （范围，19-68） 岁。中位随访时间为 8.9 （范围，0.2-16.7） 年。在随访期间，6 例移植物丢失，2 例患者再次移植。有 10 名患者死亡，其中 2 名因移植而丢失。移植的 5 年和 10 年生存率分别为 85% （SD， 5%） 和 74% （SD， 7%）。世界上移植的序号是生存的重要预测因子（风险比，95;95% CI，90-100;P <05）. 丢失的移植物每年急性排斥反应发作的中位数为 1.2 （范围，0-5.3），存活的移植物每年的中位数为 0.7 （范围，0-4.6）。 未检测到与患者和移植变量的移植存活率或排斥反应发作次数的相关性。结论和相关性在这项研究中，面部移植的总生存率令人鼓舞。这些数据表明，面部移植可接受的长期生存率使其成为广泛面部缺陷的重建选择。