Composite Tissue Allotransplantation of the Hand and Face
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Vascularized Composite Allografts (Lc Cendales, Section Editor)
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Curr Transpl Rep (2014) 1:173–182 DOI 10.1007/s40472-014-0025-6 VASCULARIZED COMPOSITE ALLOGRAFTS (LC CENDALES, SECTION EDITOR) Vascularized Composite Allografts: Procurement, Allocation, and Implementation Axel Rahmel Published online: 3 July 2014 # The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Vascularized composite allotransplantation is a allotransplantation. In 2005, the first face transplantation was continuously evolving area of modern transplant medicine. performed in Lyon [5]; since then the number of face trans- Recently, vascularized composite allografts (VCAs) have plants has increased [6]. This special category of transplants is been formally classified as ‘organs’.Inthisreview,keyas- localized at the border between tissue and organ transplanta- pects of VCA procurement are discussed, with a special focus tion. The term composite tissue allotransplantation (CTA) on interaction with the procurement of classical solid organs. used in the past reflects that it was often considered as a In addition, options for a matching and allocation system that special type of tissue transplantation [7]. Several reports ensures VCA donor organs are allocated to the best-suited looking in-depth at limb and face transplantation made it clear recipients are looked at. Finally, the different steps needed to that vascularized composite allotransplantation is in central promote VCA transplantation in society in general and in the aspects more similar to organ than to tissue transplantation medical community in particular are highlighted. [7–12]. After careful evaluation involving the transplant com- munity and the general public, the United States Department of Health and Human Services recently published its decision Keywords Transplantation . -
Actant Stories and the Australian Xenotransplantation Network
Constructing and Fracturing Alliances: Actant Stories and the Australian Xenotransplantation Network Copyright - Neil Leslie, Wellcome Images; reproduced with permission Peta S. Cook BPhoto; BSocSc (Sociol.) (hons.) Humanities Research Program Queensland University of Technology Submitted in full requirement for the degree of Doctor of Philosophy 2008 “The XWP [Xenotransplantation Working Party] agree that, in retrospect, a sociologist would have been a useful addition to the group to help understand these issues” (Xenotransplantation Working Party 2004: 14, emphasis added). - i - Keywords sociology; xenotransplantation; transplantation; allotransplantation; actor-network theory; science and technology studies; public understanding of science (PUS); critical public understanding of science (critical PUS); scientific knowledge; public consultation; risk; animals - ii - Abstract Xenotransplantation (XTP; animal-to-human transplantation) is a controversial technology of contemporary scientific, medical, ethical and social debate in Australia and internationally. The complexities of XTP encompass immunology, immunosuppression, physiology, technology (genetic engineering and cloning), microbiology, and animal/human relations. As a result of these controversies, the National Health and Medical Research Council (NHMRC), Australia, formed the Xenotransplantation Working Party (XWP) in 2001. The XWP was designed to advise the NHMRC on XTP, if and how it should proceed in Australia, and to provide draft regulatory guidelines. During the period -
Composite Tissue Allotransplantation of the Hand and Face
Medical Policy Composite Tissue Allotransplantation of the Hand and Face Table of Contents • Policy: Commercial • Coding Information • Information Pertaining to All Policies • Policy: Medicare • Description • References • Authorization Information • Policy History Policy Number: 662 BCBSA Reference Number: 7.03.13 NCD/LCD: NA Related Policies None Policy Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Medicare HMO BlueSM and Medicare PPO BlueSM Members Composite tissue allotransplantation of the hand and/or face is considered INVESTIGATIONAL. Prior Authorization Information Inpatient • For services described in this policy, precertification/preauthorization IS REQUIRED for all products if the procedure is performed inpatient. Outpatient • For services described in this policy, see below for products where prior authorization might be required if the procedure is performed outpatient. Outpatient Commercial Managed Care (HMO and POS) This is not a covered service. Commercial PPO and Indemnity This is not a covered service. Medicare HMO BlueSM This is not a covered service. Medicare PPO BlueSM This is not a covered service. CPT Codes / HCPCS Codes / ICD Codes Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. Please refer to the member’s contract benefits in effect at the time of service to determine coverage or non-coverage as it applies to an individual member. 1 Providers should report all services using the most up-to-date industry-standard procedure, revenue, and diagnosis codes, including modifiers where applicable. CPT Codes There are no specific CPT codes for this procedure. Description Composite Tissue Allotransplantation Composite tissue allotransplantation refers to the transplantation of histologically different tissue that may include skin, connective tissue, blood vessels, muscle, bone, and nerve tissue. -
AAHS News Draft.Pmd
A publication of the American Association for Hand Surgery Fall 2012 INSIDE THIS ISSUE ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ ○○○○○○○○○○○○○○ ○○○○○○○○○○○ From the Editor’s Desk 2 ○○○○○○○○○ MESSAGE FROM THE PRESIDENT Research Grants 2 Calendar 3 WHERE ARE WE NOW? Hand Therapist’s Corner 4 The American Associa- structured combined AAHS/ ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ tion for Hand Surgery ASHT Specialty Day under remains a vibrant organiza- the direction of Sharon Coding Corner 5 ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ tion reflecting the interests Andruskiwec PT/ CHT and AAHS Website 6 and energies of its many David Ring, MD. The one ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ volunteer members and day program entitled History Corner 7 leadership. The membership “Movement” will feature reflects a variety of individu- instructional courses; Jesse B. Jupiter, MD Practice Corner 8 als—all with a common surgical and rehabilitation courses; podium panels; Panel Discussion: purpose in providing panels, and several work- Hand Transplantation 9 outstanding care to patients shops—all featuring both two minute presentations; with problems involving the surgeon and therapist and featured surgical Hand Surgery upper limb. The member- expert speakers. This full videos. Our other guest Endowment 13 ship continues to grow with day program will run lecturers will be Dr. James 89% physicians almost simultaneously with the May Jr., former AAHS Leadership Profile: equally divided between first day of the AAHS President; Dr. Diego David Ring, MD 21 plastic surgery and ortho- meeting with both groups Fernandez from Berne paedic surgery training, as joining together for our Switzerland; and our Board of Directors 22 well as 11% health care guest lecturer Dr. Eduardo combined guest with the providers involved in the Zancolli Jr. of Buenos Aires, ASPN and ASRM will be evaluation and rehabilitation Argentina. -
Hand Transplantation Open Access to Scientific and Medical Research DOI
Journal name: Transplant Research and Risk Management Article Designation: Review Year: 2017 Volume: 9 Transplant Research and Risk Management Dovepress Running head verso: Alolabi et al Running head recto: Hand transplantation open access to scientific and medical research DOI: http://dx.doi.org/10.2147/TRRM.S94298 Open Access Full Text Article REVIEW Hand transplantation: current challenges and future prospects Noor Alolabi1 Abstract: Over the last two decades, 113 vascularized composite allotransplantation (VCA) Haley Augustine1 of the hand have been performed in 76 patients globally. The procedure that was once regarded Achilles Thoma1–3 as experimental has certainly emerged as a clinical reality with multiple centers worldwide now performing it. The psychological and physical impact of losing an upper extremity is 1Division of Plastic Surgery, Department of Surgery, 2Surgical profound. Amputees face significant challenges contributing to disability and dependence even Outcomes Research Centre, with activities of daily living. Hand transplantation offers functions with restoring sensation, 3 Department of Clinical Epidemiology voluntary motor control, and proprioception, as well as a sense of feeling “whole” again. Along and Biostatistics, McMaster University, Hamilton, ON, Canada with these benefits, however, transplantation carries a significant risk profile attributed to the complications of life-long immunosuppression and possible rejection. Moreover, the procedure For personal use only. carries a significant financial burden to the health care system. As hand VCA is becoming more widely accepted and performed worldwide, there are still many challenges that will face its rapid growth. This review highlights some of the challenges facing hand VCA including patient selection, effect on quality of life, financial burden, functional outcomes, and complications of immunosuppression. -
James L. Benedict a Revised Consent Model for the Transplantation of Face and Upper Limbs: Covenant Consent International Library of Ethics, Law, and the New Medicine
International Library of Ethics, Law, and the New Medicine 73 James L. Benedict A Revised Consent Model for the Transplantation of Face and Upper Limbs: Covenant Consent International Library of Ethics, Law, and the New Medicine Volume 73 Series editors David N. Weisstub, University of Montreal Fac. Medicine, Montreal, QC, Canada Dennis R. Cooley, North Dakota State University, History, Philosophy, and Religious Studies, Fargo, ND, USA Founded by Thomasine Kimbrough Kushner, Berkely, USA David C. Thomasma, Dordrecht, The Netherlands David N. Weisstub, Montreal, Canada The book series International Library of Ethics, Law and the New Medicine comprises volumes with an international and interdisciplinary focus. The aim of the Series is to publish books on foundational issues in (bio) ethics, law, international health care and medicine. The 28 volumes that have already appeared in this series address aspects of aging, mental health, AIDS, preventive medicine, bioethics and many other current topics. This Series was conceived against the background of increasing globalization and interdependency of the world’s cultures and govern- ments, with mutual influencing occurring throughout the world in all fields, most surely in health care and its delivery. By means of this Series we aim to contribute and cooperate to meet the challenge of our time: how to aim human technology to good human ends, how to deal with changed values in the areas of religion, society, culture and the self-definition of human persons, and how to formulate a new way of thinking, a new ethic. We welcome book proposals representing the broad interest of the interdisciplinary and international focus of the series. -
The Question of Identity Between the Restorative and Regenerative Organ Transplantations
Revelation and Science Vol. 08, No. 02 (1440H/2018) 13-20 The Question of Identity between the Restorative and Regenerative Organ Transplantations 1Ibrahim Shogar*, 2Nazri Mohd Yusof, 1Mohamad Ariff Bin Mohamad Yussoff, 1Mohd. Azid Bin Mat Din, 1Iswatun Hasanah Bt. Abdullah Ripain, 1Iffah Inani Bt. Hashim, 1Fatihah Bt. Mohd. Yusof 1Kulliyyah of Science, 2Kulliyyah of Medicine, International Islamic University Malaysia, IIUM. Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200 Kuantan, Pahang Darul Makmur, Malaysia Abstract This paper explores implications of organ transplantation on identity and body integrity. It investigates how advancements in transplant technologies can affect and reshape our conception of identity at individual and social levels. The question of identity as a distinctive code for every organism is increasingly becoming important due to the advanced biomedical technologies and its legal, ethical, and social implications. Modes of organ transplantation, in this paper are divided into two major types (i) restorative and (ii) regenerative. Both types have important implications on conception of identity, at various levels, from both biological and social perspectives. While highlighting all these dimensions, this article focuses on implications of restorative organ transplantation on identity based on four specific cases, which are: (i) hand transplantation, (ii) facial transplantation, (iii) reproductive organ transplantation, and (iv) head / body transplantation. Investigating all these cases, the paper has concluded that while the advanced biomedical technology is essential for survival of many lives, application of such technologies must be consistent with moral values and the universal principles for human dignity and body integrity. Keyword: Organ transplantation, loss of personal identity, cyborg, body transplant, ethical questions. -
Ethical Criteria for Uterine Transplant Recipients & Donors in Clinical Practice
ETHICAL CRITERIA FOR UTERINE TRANSPLANT RECIPIENTS & DONORS IN CLINICAL PRACTICE BY MARGARET ELIZABETH HORVAT A Thesis Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL OF ARTS AND SCIENCES in Partial Fulfillment of the Requirements for the Degree of MASTER OF ARTS Bioethics December 2018 Winston-Salem, North Carolina Approved By: Ana Iltis, Ph.D., Advisor Nancy M.P. King, JD, Chair Rich Robeson DEDICATION AND ACKNOWLEDGEMENTS This feat would not have been possible without the persistence and help of my advisor, Dr. Ana Iltis. She patiently pushed me to think deeper and challenge my initial conclusion. Ana, your teaching has not only influenced my work, but the way I think through questions in life in general. To my sweet husband, Jake Horvat, thank you for bearing with me as I pursued this degree. I would not be here if not for your love and encouragement. I am unbelievably lucky and grateful to have you by my side and pushing me to try new things and pursue scary dreams. Lastly, this work is dedicated to my parents Robert and Lisa Weiss. Stories of your struggles with infertility are what initially spurred me on to study Bioethics many years ago. Thank you for taking on the burdens, risks, and immense joys of In vitro fertilization and adoption to make the Weisses a family of four. You made this journey of graduate school a reality and allowed me to learn more about something I love, I truly could not have done this without you. ii TABLE OF CONTENTS LIST OF ABBREVIATIONS ................................................................................................ -
Clinical Guidelines for Organ Transplantation from Deceased Donors Version 1.5 – April 2021
The Transplantation Society of Australia and New Zealand Clinical Guidelines for Organ Transplantation from Deceased Donors Version 1.5 – April 2021 Produced in partnership with Version 1.0 of the Clinical Guidelines for Organ Transplantation from Deceased Donors (the Clinical Guidelines) was released in April 2016. Updates were made in May 2017 (Version 1.1), December 2018 (Version 1.2), May 2019 (Version 1.3), and July 2020 (Version 1.4). The current document, Version 1.5 (April 2021), replaces these previous versions of the Clinical Guidelines. Version control Version # Changes made Approved by Date 1.5 Updated advice related COVID-19 (section 2.3.2.1). Australasian Transplant 28 April 2021 Addition of advice in the event of reactive screening antibody Coordinators Association results (section 2.3.2.9). (ATCA), Transplant Society of Australia and New Zealand Addition of section 2.5 on Risks related to other donor (TSANZ) and Organ and conditions. Tissue Authority (OTA). Updates relating to the Australian and New Zealand paired Kidney Exchange Program (ANZKX) (sections 5.2.5 and 5.4.4). 1.4 Chapter 11 (Paediatric Donors) was added to the Guidelines, Paediatric Donor Working 24 July 2020 providing organ-specific advice on acceptability and allocation Group. Australasian of organs from paediatric donors. Each of the organ- Transplant Coordinators specific chapters in Part B were updated to reflect the new Association (ATCA), recommendations for paediatric donors. Transplant Society of Australia and New Zealand Addition of advice on COVID-19 screening in deceased (TSANZ) and Organ and donors. Tissue Authority (OTA) 1.3 Broad revisions to section 2.3 (Donor assessment) and Australasian Transplant 31 May 2019 section 2.4 (Donor transmitted infectious disease). -
Face Transplantation: on the Verge of Becoming Clinical Routine?
Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 907272, 9 pages http://dx.doi.org/10.1155/2014/907272 Review Article Face Transplantation: On the Verge of Becoming Clinical Routine? Ralf Smeets, Carsten Rendenbach, Moritz Birkelbach, Ahmed Al-Dam, Alexander Gröbe, Henning Hanken, and Max Heiland Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany Correspondence should be addressed to Ralf Smeets; [email protected] Received 11 December 2013; Revised 15 February 2014; Accepted 21 May 2014; Published 9 June 2014 Academic Editor: Andrea Ferri Copyright © 2014 Ralf Smeets et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Face transplantation (FT) is an innovative achievement of modern reconstructive surgery and is on the verge of becoming a common surgical opportunity. This review article was compiled to provide an update on this surgical field, especially regarding clinical outcomes, benefits, and complications implied. Methods. We performed an extensive research on all English- language Medline articles, case reports, and reviews published online until September 15, 2013. Used search terms were “face transplantation,” “face transplant,” “facial transplantation,” “facial transplant,” “face allograft,” and “facial allograft.” Results.Todate 27 FTs have been performed worldwide. 19 of these cases have been published in the Medline database. Long-term follow-up reports of FT cases are rare. Three deaths associated with the procedure have occurred to date. The clinical outcomes of FT are satisfying. -
The Promise of Organ and Tissue Preservation to Transform Medicine
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Nat Biotechnol Manuscript Author . Author Manuscript Author manuscript; available in PMC 2017 December 11. Published in final edited form as: Nat Biotechnol. 2017 June 07; 35(6): 530–542. doi:10.1038/nbt.3889. The promise of organ and tissue preservation to transform medicine Sebastian Giwa1,2,3,46, Jedediah K Lewis1,46, Luis Alvarez4,5,6, Robert Langer7, Alvin E Roth8, George M Church9, James F Markmann10, David H Sachs11, Anil Chandraker12,13, Jason A Wertheim14,15, Martine Rothblatt16, Edward S Boyden17, Elling Eidbo18, W P Andrew Lee19, Bohdan Pomahac20, Gerald Brandacher19, David M Weinstock21, Gloria Elliott22, David Nelson23, Jason P Acker24,25, Korkut Uygun26, Boris Schmalz1,27, Brad P Weegman1,2, Alessandro Tocchio1,28, Greg M Fahy29, Kenneth B Storey30, Boris Rubinsky31, John Bischof32, Janet A W Elliott24,33, Teresa K Woodruff34, G John Morris35, Utkan Demirci28,36, Kelvin G M Brockbank37, Erik J Woods3,25,38, Robert N Ben39, John G Baust40, Dayong Gao25,41, Barry Fuller42, Yoed Rabin43, David C Kravitz44, Michael J Taylor2,43,45, and Mehmet Toner26 1Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA 2Sylvatica Biotech, Inc., Charleston, South Carolina, USA 3Ossium Health, San Francisco, California, USA 4Regenerative Biology Research Group, Cancer and Developmental Biology Laboratory, National Cancer Institute, Bethesda, Maryland, USA 5Walter Reed National Military Medical Center, Bethesda, Maryland, USA 6Department of Chemistry and Life Science, United States Military Academy, West Point, New York, USA 7Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA 8Department of Economics, Stanford University, Stanford, California, USA 9Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA Reprints and permissions information is available online at http://www.nature.com/reprints/index.html. -
Complex Facial Reconstruction by Vascularized Composite Allotransplantation: the first Belgian Case* Nathalie A
Journal of Plastic, Reconstructive & Aesthetic Surgery (2015) 68, 362e371 Complex facial reconstruction by vascularized composite allotransplantation: The first Belgian case* Nathalie A. Roche a,*, Hubert F. Vermeersch b, Filip B. Stillaert a, Kevin T. Peters a, Jan De Cubber c, Kristiane Van Lierde d, Xavier Rogiers e, Luc Colenbie e, Patrick C. Peeters f, Gilbert M.D. Lemmens g, Phillip N. Blondeel a a Department of Plastic and Reconstructive Surgery, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium b Department of Head and Neck Surgery, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium c Center for Craniofacial Epithetics, Guldendelle 35, 1930 Zaventem, Belgium d Department of Speech, Language and Hearing Sciences, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium e Department of Transplant Surgery, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium f Department of Nephrology, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium g Department of Psychiatry and Medical Psychology, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium Received 5 June 2014; accepted 8 November 2014 KEYWORDS Summary Introduction: Complex injuries to the central part of the face are difficult to Vascularized reconstruct with the current plastic surgery methods. The ultimate one-staged approach to composite restore anatomy and vital facial functions is to perform a vascularized composite allotrans- allotransplantation; plantation (VCA). Face transplant; Methods: A 54-year-old man suffered from a high-energy ballistic injury, resulting in a large 3D CT modeling; central facial defect. A temporary reconstruction was performed with a free plicated antero- Multidisciplinary lateral thigh (ALT) flap. Considering the goal to optimally restore facial function and aes- team approach thetics, VCA was considered as an option for facial reconstruction.