Follow-up on Functional Outcomes of Face Transplantation

Purpose

This study provides pre-operative functional impairments and post-operative outcomes of all face transplantations(FT) worldwide.

Methods

Between 2005and2014, 30FTs were performed worldwide. Functional outcomes were defined as the ability to smell, breathe, eat, speak, generate facial expressions and experience facial sensation. The 7FT recipients of our institution were physically examined and documented via photo/video recording as well as imaging-based airway volume measurements. Outcomes of the remaining 24FT were quoted from peer-reviewed literature.

Results

Before FT, all of our 6patients had limitations in their abilities to breathe, eat, speak, generate facial expressions and experience facial sensation. The ability to smell was compromised in 2out of 7patients. Two patients were dependent on tracheostomy and 1was dependent on gastrostomy tubes. After a mean follow-up of 3.5years, all functional outcomes significantly improved. Progressive re-innervation of facial skin and muscles improved or enabled eating, speaking and the ability to produce facial expressions and experience facial sensation. There was significant increase in upper airway volumes, leading to improvements in breathing and smelling. All artificial airways and feeding tubes were removed. In all other FT recipients worldwide the ability to smell, eat and feel was improved in 100%of cases, whereas the ability to breath, speak and grimace was ameliorated in 93%,71%and76%, respectively. Almost 60%of outcomes were not reported.

Conclusion

This study demonstrates the effectiveness of FT by restoring facial functions. Future reports should provide similar descriptive information in order to increase the available evidence and thus overcome the experimental state of FT.