Long-term posttransplant-related bone volumetric changes in eight face transplant recipients - A single-center retrospective case series

Huelsboemer, Lioba and Boroumand, Sam and Boroumand, Tara and Vafa, Aliyar Zahedi and Parikh, Neil and Chiarella, Laetitia S. and Knoedler, Leonard and Stoegner, Viola A. and Hung, Peter and Sadigh, Sam and Haykal, Siba and Pomahac, Bohdan and Kauke-Navarro, Martin (2025) Long-term posttransplant-related bone volumetric changes in eight face transplant recipients - A single-center retrospective case series. JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 101. pp. 220-230. ISSN 1748-6815, 1878-0539

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Abstract

Background: The long-term stability of allograft or native bone in facial vascularized composite allograft (fVCA) recipients is unclear. This study quantified long-term bone volume changes in facial transplants. Methods: Computed tomography scans of eight fVCA recipients (2011-2023) were analyzed with Materialise Mimics. Native bone (soft tissue-only VCAs, n=4) and allotransplanted bone (n=4) were compared. Median bone volumes were assessed for significance using the WilcoxonRanked-Sum Test. Results: Mean follow-up was 10 years (range 5-13). A significant median decrease in both mandibular (-6520 mm3; p=0.0078) and maxillary (-3548 mm3; p=0.0078) bone volumes was seen in all patients, irrespective of bone origin. Median bone volume loss was -9.92% in the bony allograft cohort and -22.60% in the soft tissue-only cohort, respectively. The histo- pathological analysis of the limited samples (n=2) showed physiological bone even after ten years. Conclusion: Patients with allotransplanted bone showed less pronounced volume loss com- pared to those with native bone receiving soft tissue-only allografts. This finding suggests that allotransplanted vascularized bone in fVCAs may not be a primary target of chronic rejection processes that compromise bone volume stability and functionality. Bone volume changes are likely influenced by multiple factors, such as tooth loss, nutrition, chronic immunosuppression (e.g., steroids), mechanical stress/load, varying bone remodeling rates, and other medical comorbidities. Further research is needed to clarify the factors affecting bone volume and remodeling after fVCA. (c) 2024 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.

Item Type: Article
Uncontrolled Keywords: VASCULARIZED COMPOSITE ALLOTRANSPLANTATION; MINERAL DENSITY; CYCLOSPORINE; REJECTION; METABOLISM; QUALITY; FK506; SKIN; Bone volume measurement; Face transplant; Facial Vascularized Composite Allotransplantation; FVCA; Facial allograft; Reconstructive surgery
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Depositing User: Dr. Gernot Deinzer
Date Deposited: 02 Jun 2026 12:16
Last Modified: 02 Jun 2026 12:16
URI: https://pred.uni-regensburg.de/id/eprint/67370

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