What Is The True Significance of Donor-Related Cytomegalovirus Transmission in the Setting of Facial Composite Tissue Allotransplantation?

• Published in: Transplantation proceedings Vol. 43; no. 9; pp. 3516 - 3520
• Main Authors: Gordon, C.R, Abouhassan, W, Avery, R.K
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2011; Elsevier
• Subjects: Antiviral Agents - pharmacology; Biological and medical sciences; Cytomegalovirus - metabolism; Cytomegalovirus Infections - transmission; Facial Transplantation - adverse effects; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Infectious diseases; Medical sciences; Opportunistic Infections - transmission; Organ Transplantation - adverse effects; Postoperative Complications; Risk; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Donors; Tissue, organ and graft immunology; Transplantation, Homologous; Viral diseases; Suboptimal donor; Composite graft; Human; Opportunistic infection; Herpesviridae; Transmission; Definition; Health service; Transplantation; Homotransplantation; Betaherpesvirinae; Human cytomegalovirus; Infection; Virus; Medicine; Tissue; Treatment; Surgery; Viral disease; Graft; Face
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.08.043

Abstract Face transplantation (FT) is fraught with complications parallel to solid organ transplantation (SOT). As such, donor-related cytomegalovirus (CMV) transmission remains one of the most commonly feared viruses associated with FT. With this in mind, a review of the literature seemed justified, knowing that two of the first four face transplant recipients acquired CMV donor-related viral infection. Although the risk of CMV transmission is acceptable in the setting of SOT, the scenario for those composite tissue allotransplantation (CTA) patients, who are often young and healthy, may be different. Experiences from France and Cleveland have both confirmed suboptimal events related to CMV transmission following transplantation. Therefore, using the information provided here, it is imperative that all FT teams remain aware of these potential risks. Furthermore, all patients pursuing facial CTA should be fully informed as to the risks of donor-related CMV transmission, understand the importance of prophylaxis, and be aware of alternative therapies required to prevent symptomatic disease.