{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:36:29Z","timestamp":1783996589934,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T00:00:00Z","timestamp":1494460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:p>We describe the first rescue procedure in a case of total face allotransplantation. The recipient was a 54\u2010year\u2010old man with severe disfigurement of the entire face following an accidental gunshot injury 5\u00a0years previously. The large defect included the maxilla, mandible, and mid\u2010face. Full face procurement was performed from a multiorgan cadaveric donor and was allotransplanted to the recipient. The post\u2010transplant induction immunosuppressive regimen included ATG combined with tacrolimus, mycophenolate mofetil, and prednisone, while maintenance was provided by the last three of these. Although the early postoperative period was uneventful, squamous cell carcinoma developed in the upper and lower extremities in the fifth postoperative month, and post\u2010transplant lymphoproliferative disorder (PTLD) occurred in the sixth month postoperatively. Malignancies were treated, involving both surgical and medical approaches. The patient developed opportunistic pulmonary and cerebellar aspergillosis. In order to reduce the adverse affects and metabolic and immunological load, the transplanted face was removed and replaced with a free flap. Although the early postoperative period was promising, with the transferred flap surviving totally and all vital signs and general status appearing to be improving, the patient was eventually lost due to complicated infectious and metabolic events. Although this case was unsuccessful, we suggest that the immunological and metabolic load should be reduced as soon as stable medical conditions are established in case of diagnosis of a situation involving a high rate of mortality, such as PTLD and untreatable opportunistic infections. This should include withdrawal of all immunosuppressive drugs and removal of all allotransplanted tissues.<\/jats:p>","DOI":"10.1002\/micr.30137","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T13:53:03Z","timestamp":1494510783000},"page":"661-668","source":"Crossref","is-referenced-by-count":36,"title":["Consideration of difficulties and exit strategies in a case of face allotransplantation resulting in failure"],"prefix":"10.1002","volume":"37","author":[{"given":"\u00d6zlenen","family":"\u00d6zkan","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"\u00d6zkan","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umuttan","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vural Taner","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Nephrology Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilmi","family":"Uysal","sequence":"additional","affiliation":[{"name":"Department of Neurology Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levent","family":"\u00dcndar","sequence":"additional","affiliation":[{"name":"Department of Hematology Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru Apayd\u0131n","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Neurology Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozan","family":"Salim","sequence":"additional","affiliation":[{"name":"Department of Hematology Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An\u0131","family":"\u00c7inpolat","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atilla","family":"Ramazanoglu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24032"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318255a411"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-62703-493-7_5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68935-6"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24211"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181ba5245"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61276-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12301"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001248"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/356459"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1097\/MOT.0000000000000025","article-title":"Monitoring and long\u2010term outcomes in vascularized composite allotransplantation","volume":"18","author":"Kaufman C. 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