{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:36:16Z","timestamp":1783996576385,"version":"3.55.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,10,6]],"date-time":"2017-10-06T00:00:00Z","timestamp":1507248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Patient Experience"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Most solid organ transplantation is viewed as lifesaving, whereas vascularized composite allotransplantation (VCA) has been viewed as life enhancing. This article challenges the latter and argues that \u201csocial death\u201d evident in severe face, hand, and larynx disfigurement can be potentially treated via VCA. Social death (from a social science perspective) consists of a combination of 7 components: social isolation, loneliness, ostracism, loss of personhood, change of role and identity, harm, and disfigurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In February 2016, PubMed and Google were searched for case reports of human face, hand, and larynx transplantation. Patient and team narratives were then coded for components of social death using social science and medical model criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eleven narratives were identified among 9 articles. The social science model (but not the medical model) described pretransplant social death and the resolution of social death by receiving VCA. Notably, the medical model of social death was deemed unsuitable for application to VCA. This is because case narratives consistently contradict elements of the medical model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>By including social death as a patient inclusion criterion for face, hand, and larynx VCA, these transplants can be considered lifesaving. Additionally, because VCA requires lifelong immunosuppressant medication, considering VCA as a lifesaving intervention improves the technology\u2019s risk\u2013benefit analysis. Guidance for assessing social death is provided.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2374373517730556","type":"journal-article","created":{"date-parts":[[2017,10,6]],"date-time":"2017-10-06T08:44:38Z","timestamp":1507279478000},"page":"92-100","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["A Lifesaving View of Vascularized Composite Allotransplantation"],"prefix":"10.1177","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5446-0123","authenticated-orcid":false,"given":"Katrina A","family":"Bramstedt","sequence":"first","affiliation":[{"name":"Bond University School of Medicine, University Drive, Gold Coast, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,10,6]]},"reference":[{"key":"bibr1-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000892"},{"key":"bibr2-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2015.11681077"},{"key":"bibr3-2374373517730556","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.9602"},{"key":"bibr4-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61728-1"},{"key":"bibr5-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ff1472"},{"key":"bibr6-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1177\/1753193414559463"},{"key":"bibr7-2374373517730556","unstructured":"BlueCross BlueShield of Alabama. Policy# 521: composite tissue allotransplantation (CTA) of the hand and face. 2 2016. https:\/\/www.bcbsal.org\/providers\/policies\/final\/521.pdf. Updated August 30, 2017. Accessed January 28, 2016."},{"key":"bibr8-2374373517730556","unstructured":"Aetna. Policy# 0819: face transplantation. 2016. http:\/\/www.aetna.com\/cpb\/medical\/data\/800_899\/0819.html. Updated August 30, 2017. Accessed January 28, 2016."},{"key":"bibr9-2374373517730556","unstructured":"Transplantation Society of Australia and New Zealand. Vascularised Composite Allotransplantation. In: Organ Transplantation from Deceased Donors: Eligibility Criteria and Allocation Protocols: Background Review; https:\/\/www.tsanz.com.au\/organallocationguidelines\/documents\/ClinicalGuidelinesV1.1May2017.pdf. Accessed August 30, 2017."},{"key":"bibr10-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2013.844746"},{"key":"bibr11-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-9004.2007.00004.x"},{"key":"bibr12-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1177\/1745691614568352"},{"key":"bibr13-2374373517730556","doi-asserted-by":"publisher","DOI":"10.2190\/L0N6-P489-NR8N-JQ6K"},{"key":"bibr14-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1177\/1357034X14536448"},{"key":"bibr15-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-8525.1998.tb00513.x"},{"key":"bibr16-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcw183"},{"key":"bibr17-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1080\/21582041.2015.1114407"},{"key":"bibr18-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemep.2015.10.015"},{"key":"bibr19-2374373517730556","first-page":"311","volume":"21","author":"K\u00f6nigov\u00e1 R","year":"1987","journal-title":"Scand J Plast Reconstr Surg Hand Surg"},{"key":"bibr20-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9566.1997.tb00017.x"},{"key":"bibr21-2374373517730556","first-page":"200","volume":"2","author":"Mattoo K","year":"2014","journal-title":"Am J Med Case Rep"},{"key":"bibr22-2374373517730556","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0358.73452"},{"key":"bibr23-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-2001.2003.tb00779.x"},{"key":"bibr24-2374373517730556","unstructured":"University of Limerick. Impairment and disability short course: physiotherapy in burns, plastics and reconstructive surgery. 2013. https:\/\/www.physio-pedia.com\/images\/3\/30\/Burns_and_Plastics.pdf. Accessed August 30, 2017."},{"key":"bibr25-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1177\/1049732307312070"},{"key":"bibr26-2374373517730556","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072828"},{"key":"bibr27-2374373517730556","unstructured":"Bernard A, Smith CS. French face-transplant patient tells of her ordeal. New York Times. February 7, 2006. http:\/\/www.nytimes.com\/2006\/02\/07\/world\/europe\/frenchfacetransplant-patient-tells-of-her-ordeal.html. 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Clinical Ethics. 3 rd ed. 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