{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:37:05Z","timestamp":1770755825722,"version":"3.50.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Rejection represents a major and common complication in vascularized composite allotransplantation (VCA). Over time, recurrent acute or chronic rejection can lead to vascular and dermal fibrosis and potentially graft loss. To date, a non\u2010invasive monitoring tool to capture chronic graft changes among VCA recipients has not been established. This pilot study aims to assess the potential value of noninvasive skin elasticity measurements for surveillance of longitudinal fibrosis of facial allografts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Viscoelasticity was non\u2010invasively assessed via triplicate measurements of the transplanted facial skin on bilateral cheeks and native skin on bilateral upper arms in six face transplant recipients using the well\u2010established Cutometer\u00a0Dual MPA 580. Data were statistically compared with recipient\/donor age, post\u2010transplant years (PTYs), and cumulative rejection burden (CRB), smoking status, ethnicities, and immunosuppressive regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) negative linear relationship between CRB and the Cutometer parameters R2 (gross elasticity), R5 (net elasticity), and R7 (elasticity recovery) was found, which was not observed in control measurements of native skin of VCA recipients. Results were ranked into a three\u2010level severity scale. Comparison with PTYs further revealed a significant negative linear relationship with R2 and R5 values. No statistically significant correlation was detected across R values when evaluated against recipient\/donor age, smoking status, ethnicity, or immunosuppressive regimens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although diagnosis and monitoring of rejection\u2010associated degenerative skin changes currently still rely on biopsies, this exploratory study identifies skin elasticity as a promising surrogate marker for facial allograft fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70175","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T13:43:38Z","timestamp":1748958218000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Skin Elasticity: A Potential Surrogate Marker for Facial Allograft Skin Fibrosis\u2014A Case Series"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-4762","authenticated-orcid":false,"given":"Viola A.","family":"St\u00f6gner","sequence":"first","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery Department of Surgery Yale School of Medicine  New Haven Connecticut USA"},{"name":"Hannover Medical School Department of Plastic Aesthetic, Hand and Reconstructive Surgery, Burn Center  Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0736-1610","authenticated-orcid":false,"given":"Sam","family":"Boroumand","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery Department of Surgery Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliyar Zahedi","family":"Vafa","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery Department of Surgery Yale School of Medicine  New Haven Connecticut USA"},{"name":"KU Leuven, Faculty of Medicine  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4795-0225","authenticated-orcid":false,"given":"Lioba","family":"Huelsboemer","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; 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