Clinicopathologic monitoring of the skin and oral mucosa of the first human face allograft:: Report on the first eight months

被引:81
作者
Kanitakis, Jean [1 ]
Badet, Lionel
Petruzzo, Palmina
Beziat, Jean Luc
Morelon, Emmanuel
Lefrancois, Nicole
Frances, Camille
Claudy, Alain
Martin, Xavier
Lengele, Benoit
Testelin, Sylvie
Devauchelle, Bernard
Dubernard, Jean Michel
机构
[1] Hop Edouard Herriot, Dept Dermatol, F-69437 Lyon 03, France
[2] Hop Edouard Herriot, Dept Transplantat Surg, F-69437 Lyon, France
[3] Hosp Nord, Dept Maxillofacial Surg, Lyon, France
[4] Hop Edouard Herriot, Dept Immunol & Nephrol, F-69437 Lyon 03, France
[5] Tenon Hosp, Dept Dermatol, Paris, France
[6] Univ Catholique Louvain, Expt Morphol Dept, B-1200 Brussels, Belgium
[7] Amiens Univ Hosp, Dept Maxillofacial Surg, Amiens, France
关键词
facial allograft; skin; oral mucosa; rejection; pathology;
D O I
10.1097/01.tp.0000248780.55263.33
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. The first human face allograft was performed in France on November 27, 2005. We report herein the clinicopathologic findings from the skin and oral mucosa of this allograft during the first eight months. Methods. Sequential biopsies were taken from the facial skin (n=3), oral mucosa (n=20), and sentinel skin graft (n=1.1) from day 3 to day 220 postgraft and examined (immuno) histologically, using a pathological score previously proposed for evaluation of rejection in composite tissue (hand) transplantation. Results. The patient developed clinically rejection episodes at day 20 and during the eighth month postgraft, manifesting with redness and edema of the facial skin, oral mucosa, and sentinel graft skin. Pathologically, changes suggestive of rejection grades 0, I, II, and III were seen in 1, 1, 1, and 0 biopsies of facial skin, 7, 2, 1, and I biopsies of sentinel skin graft and 3, 5, 8, and 4 biopsies of oral mucosa, respectively. Pathological changes were generally more severe in the oral mucosa than in facial and sentinel graft skin (mean scores 1.85, 0.64, and 1, respectively). Conclusions. As it happens with other composite tissue allografts, close clinicopathologic monitoring of the skin (and oral mucosa) seems to be the most reliable way to detect rejection in the setting of human facial tissue allotransplantation. Apart from these rejection episodes, the skin and mucosa maintained a normal microscopic structure, paralleling functional recovery.
引用
收藏
页码:1610 / 1615
页数:6
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