A multidisciplinary protocol for face transplantation at Brigham and Women’s Hospital

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 64; no. 12; pp. 1572 - 1579
• Main Authors: Bueno, E.M, Diaz-Siso, J.R, Pomahac, B
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.12.2011; Elsevier
• Subjects: Biological and medical sciences; Boston; Clinical Protocols; Face transplant follow-up; Face transplant screening; Face transplantation; Face transplantation programme; Face transplantation team; Facial Transplantation - methods; Facial Transplantation - standards; Graft Rejection; Humans; Interprofessional Relations; Medical sciences; Patient Care Team - organization & administration; Patient Selection; Plastic Surgery; Postoperative Care; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue and Organ Procurement; Boston; Face transplantation programme; Face transplant screening; Face transplantation team; Face transplant follow-up; Face transplantation; Human; Graft(material); Transplantation; Medical screening; Treatment; Follow up study; Surgery; Graft; Female; Hospital; Face; Woman
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2011.07.008

Summary Face transplantation introduces an unprecedented potential to restore form and function in patients with severe facial disfigurement. A successful face transplantation programme requires a sound research protocol, a solid infrastructure, expert personnel and adequate funding. There are only a few active face transplant programmes in the world and interest in the development of new such programmes continues to grow. After 2 years of working on the development of the face transplant programme, in 2009 the team at Brigham and Women’s Hospital (BWH) performed the 2nd face transplant in the United States. Since then, the team has continued to evaluate several possible face transplant candidates and performed three additional facial transplants. These experiences have helped refine a highly effective multidisciplinary protocol that carries a patient through recruitment, informed consent, screening, preoperative planning, face transplantation surgery and postoperative long-term follow-up. The members of the BWH face transplantation team responsible for carrying out this protocol include a team leader, a programme manager/coordinator, clinical and rehabilitation specialists, social workers, bioethicists, nurses and administrative staff. The roles of each team member during the various stages of the face transplant process are presented here. Additional insight into the interaction between the face transplant team, the Institutional Review Board and the regional Organ Procurement Organization is given. The BWH team’s experience has shown that true collaboration, creativity and a unique approach to each candidate translate into the optimal care of the face transplant patient both before and after surgery.