The Barcelona Experience

Juan Barret, Universitat Autonoma de Barcelona, Barcelona, Spain.

On March 2010 the first Full Face Transplantation, including all facial bones, was performed at the University Hospital Vall d´Hebron, in Barcelona, Spain.

Similarly to other groups, preclinical and anatomical Studies were necessary to perform this achievement.

This transplant answered many questions raised beforehand, and the feasibility of the vascularization of the facial skeleton based on the facial and temporal arteries. Our patient showed active bleeding on all areas of the facial allograft and all facial bones are vital and well vascularized to date, 12 months after the transplant.

Transplanting eyelids and orbital bones and contents is also very challenging. Type III, or as in this case type V facial allografts, require a perfect match. Otherwise postoperative deformities such as hypertelorism or telecanthus may develop.

Finally, the facial allograft procurement was synchronous with the rest of the organs. This was the first time this type of procurement was performed. The technique and results will be presented.

The evaluation of candidates and the indication for facial transplants is very challenging. Our program has evaluated 13 candidates so far. The techniques and results of the evaluation will be discussed.

Learning objectives:

1. The role of full face transplants in periorbital deformities and panfacial deformities
2. Synchronous procurement of facial allografts
3. Evaluation and indication techniques