面部移植(FT)已成为严重面部畸形患者的开创性选择,由于先天性疾病,创伤,或肿瘤消融。尽管重建手术取得了重大进展,恢复形式和功能的挑战仍然存在,特别是在中心位置的缺陷。这篇综述探讨了FT的长期成果,解决它的挑战和潜在的陷阱。根据PRISMA指南进行了系统审查,包括2005年11月至2023年1月以英文发表的文章,这些文章在PubMed上进行了搜索,MEDLINE,EMBASE数据库。关键词包括“面部移植”,“\”面部移植结果,“和”面部移植长期。“手术团队的数据,患者人口统计学,移植细节,拒绝事件,额外的手术,提取并分析患者报告的结局.总的来说,34条符合纳入标准。在过去的20年里,进行了48次FT手术,23例患者随访至少3年。主要是,患者为男性(80%),平均31岁。弹道创伤(44.6%)和烧伤(25.5%)是常见的损伤原因。慢性排斥反应成为一个重要的问题,导致2例患者的移植物丢失并需要再次移植。通常需要额外的外科手术。FT为面部广泛毁容的个人提供了出色的解决方案。成功的结果取决于因素,比如病人选择,多学科合作,精神病学评估,和术后护理。然而,挑战依然存在,包括需要终生免疫抑制和慢性排斥的风险。尽管FT改变了生活,在这个不断发展的领域的持续成功取决于正在进行的研究和警惕的患者管理。
Face transplant (FT) has emerged as a groundbreaking option for patients with severe facial deformities, resulting from congenital disorders, trauma, or tumor ablation. Although reconstructive surgery has made significant strides, the challenges of restoring both form and function remain, particularly in centrally located defects. This review explored the long-term outcomes of FT, addressing its challenges and potential pitfalls. A systematic review following the PRISMA guidelines was conducted, encompassing articles published in English from November 2005 to January 2023, which were searched across PubMed, MEDLINE, and EMBASE databases. Keywords included \"face transplant,\" \"face transplant outcomes,\" and \"face transplant long-term.\" Data on surgical teams, patient demographics, transplant specifics, rejection episodes, additional surgeries, and patient-reported outcomes were extracted and analyzed. In total, 34 articles met the inclusion criteria. Over the 2 decades, 48 FT procedures were performed, with 23 patients followed for at least 3 years. Predominantly, patients were men (80%), averaging 31 years in age. Ballistic trauma (44.6%) and burns (25.5%) were common causes of injury. Chronic rejection emerged as a significant concern, leading to graft loss and necessitating retransplantation in 2 patients. Additional surgical procedures were often required. FT offers a remarkable solution for individuals with extensive facial disfigurement. Successful outcomes depend on factors, such as patient selection, multidisciplinary collaboration, psychiatric evaluation, and post-operative care. Nevertheless, challenges persist, including the need for lifelong immunosuppression and risk of chronic rejection. Although FT has transformed lives, continued success in this evolving field hinges on the ongoing research and vigilant patient management.