An encouraging sign of a successful transplant is when previously foreign matter, in the form of a kidney, heart, or other organ, connects with existing tissue, typically through new blood vessel networks between the two entities. Creating that connection in face transplant surgeries, however, is exceedingly difficult and has never been done before, until now.
A team of doctors presented three cases on Wednesday at the annual meeting of the Radiological Society of North America (RSNA) in which facial transplant recipients showed positive interaction between present and new facial tissue, the Washington Post reported. Their results, confirmed via medical imaging, could have major impacts on the field of facial reconstruction.
"All three patients included in this study at Brigham and Women's maintain excellent perfusion, or blood flow, the key element of viability of the facial tissues and the restoration of form and function to those individuals who otherwise had no face," said study co-author Frank J. Rybicki, director of the Imaging Science Laboratory at Brigham and Women's Hospital, where all three surgeries were performed. "We assumed that the arterial blood supply and venous blood return was simply from the connections of the arteries and the veins at the time of the surgery."
Facial reconstructive surgery is exceptionally difficult as it typically applies to patients who have suffered extremely challenging injuries. Doctors must not only restore normal functions relation to breathing, seeing, and eating, but also, "above all, reestablish normal human appearance," according to the RSNA.
Observable cases of relatively successful transplants give surgeons and researchers the opportunity to study how facial tissue interacts. The case studies also provide insight into how to screen potential face transplant recipients, according to Red Orbit.
"We have found that since the vessels more commonly associated with the back of the head are critical to maintain the perfusion via vascular reorganization, it is essential to visualize these vessels and determine that they are normal pre-operatively," said Dr Kanako K. Kumamaru, also of the Brigham and Women's Hospital. "Patients under consideration for face transplantation have universally had some catastrophic defect or injury."
