Face transplantation has emerged as reconstructive option for the most challenging facial deformities. A comprehensive analysis of functional outcomes, medical complications, incidence of malignancy, and chronic rejection in face transplantation recipients over an extended follow-up period has not yet been published leaving a notable gap in the literature. We retrospectively collected data of morbidity, rejection, vasculopathy, metabolic side effects, as well as functional outcome of sensory return, facial motor function, and speech from 9 patients who underwent face transplantation at Brigham and Women’s Hospital between 2009 and 2020. The median follow-up was 120 months (54 and 154 months). Four grafts (40%) developed signs of clinical and histopathologic chronic rejection without evidence of vasculopathy on computed tomography angiograms. Sensory return assessed with Weinstein enhanced sensory testing-monofilament showed an increase in 6 patients (66.7%), and facial expression analysis showed improvement throughout the whole cohort at their most recent follow-up. Speech intelligibility was stable or increasing for 5 patients (55.6%). In conclusion, the long-term outcomes reveal promising results in terms of overall graft retention and functional recovery. Metabolic, malignant, and infectious complications, as well as graft rejection episodes, are expected to occur in this population, and some may be related to patient’s age and lifestyle.

中文翻译：

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面部移植术后 10 年随访——一项单中心回顾性队列研究


面部移植已成为最具挑战性的面部畸形的重建选择。在长期随访期间，对面部移植受者的功能结果、医疗并发症、恶性肿瘤发生率和慢性排斥反应的全面分析尚未发表，这在文献中留下了明显的空白。我们回顾性收集了 2009 年至 2020 年间在布莱根妇女医院接受面部移植的 9 例患者的发病率、排斥反应、血管病变、代谢副作用以及感觉返回、面部运动功能和言语的功能结局数据。中位随访时间为 120 个月 （54 个月和 154 个月）。4 例移植物 （40%） 出现临床和组织病理学慢性排斥反应的体征，计算机断层扫描血管造影无血管病变证据。使用 Weinstein 增强感觉测试-单丝评估的感觉回报显示 6 名患者 （66.7%） 增加，面部表情分析显示在最近的随访中整个队列都有所改善。5 例患者 （55.6%） 的语音清晰度稳定或增加。总之，长期结果在整体移植物保留和功能恢复方面显示出有希望的结果。预计该人群中会发生代谢、恶性和感染性并发症以及移植物排斥反应发作，其中一些可能与患者的年龄和生活方式有关。