The Risk Profile of Face Transplant Versus Other Types of Vascularized Composite Allotransplantation Surgery—A Retrospective Multicenter Analysis

BACKGROUND: Vascularized composite allotransplantation (VCA) represents a transformative advance in reconstructive surgery, offering restoration of essential functions and psychological well-being for individuals with severe facial trauma or anomalies. There are different types of VCA. Facial vascularized composite allotransplantation (FVCA) is a complex procedure that carries the potential risk of severe complications in the event of rejection. There is a paucity of research that compares outcomes following FVCA to other types of VCA. METHODS: Data were retrieved from the Organ Procurement and Transplantation Network (OPTN) database, which provides comprehensive information on all US organ donation and transplant activities. A search identified 96 eligible VCA cases, consisting of 16 FVCAs and 80 non-FVCA cases that were included in the final analysis. RESULTS: In facial vascularized composite allotransplantation (FVCA) recipients, the median number of acute rejection episodes was significantly higher compared with non-FVCA patients [5.0 (IQR=0.0-10) versus 0.0 (IQR=0.0-2.0), P =0.0022]. Similarly, the median number of hospitalizations was greater in FVCA patients [3.0 (IQR=0.75-4.0) versus 0.0 (IQR=0.0-1.0), P