ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2019
Chronic rejection of human face allografts.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- A systematic review of treatment strategies to combat acute and chronic rejection episodes in vascularized composite allotransplantation.Frontiers in immunology · 2026Pooled it
- Challenges and opportunities in vascularized composite allotransplantation of joints: a systematic literature review.Frontiers in immunology · 2023Pooled it
- Facial vascularized composite allotransplantation: Mapping global research trends and scientific impact.JPRAS open · 2026Review
- Public perception of facial vascularized composite allotransplants-insights from a cross-sectional survey of healthy individuals in the USA.JPRAS open · 2026Article
- Diagnostic modalities in vascularized composite allotransplantation: from histopathology to multimodal strategies.Frontiers in immunology · 2026Review
- Exploratory biomarkers for acute rejection in vascularized composite allotransplantation.Frontiers in transplantation · 2026Article
- Chronic Rejection in Facial Vascularized Composite Allotransplantation (fVCA).Results and problems in cell differentiation · 2026Review
- Ten-year follow-up after face transplantation-A single-center retrospective cohort study.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Immunosuppressive and antiinfectious regimens in vascular composite allograft recipients-a systematic review.Frontiers in transplantation · 2025Review
- A comparative analysis of lesional skin, sentinel flap, and mucosal biopsies in assessing acute face transplant rejection.Frontiers in immunology · 2025Article
- Differentiation of acute versus chronic skin rejection in a rodent model of vascularized composite allotransplantation.Frontiers in immunology · 2025Article
- Continuous oxygen monitoring to enhance ex-vivo organ machine perfusion and reconstructive surgery.Biosensors & bioelectronics · 2024Article
- Autologous Tissue Repair and Total Face Restoration.JAMA otolaryngology-- head & neck surgery · 2024Article
- Mimicking Clinical Rejection Patterns in a Rat Osteomyocutaneous Flap Model of Vascularized Composite Allotransplantation.The Journal of surgical research · 2024Article
- International consensus recommendations on face transplantation: A 2-step Delphi study.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- Transcriptome profiling of immune rejection mechanisms in a porcine vascularized composite allotransplantation model.Frontiers in immunology · 2024Article
- Immunogenicity and tolerance induction in vascularized composite allotransplantation.Frontiers in transplantation · 2024Review
- Identification of lncRNA-miRNA-mRNA networks in circulating exosomes as potential biomarkers for systemic sclerosis.Frontiers in medicine · 2023Article
- Cellular activation pathways and interaction networks in vascularized composite allotransplantation.Frontiers in immunology · 2023Review
- T cell-attracting CCL18 chemokine is a dominant rejection signal during limb transplantation.Cell reports. Medicine · 2022Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 2 countries.
Funding
Abstract
Face vascularized composite allografts (FVCAs) have helped patients with severe facial disfigurement, with acute rejection now largely controlled through iatrogenic immunosuppression. However, little is known regarding the incidence and mechanism(s) of more long-term pathologic alterations in FVCAs that may affect function and graft durability. Protocol surveillance biopsy specimens for up to an 8-year interval in 7 patients who received FVCAs at our institution revealed histopathologic evidence of chronic rejection. Clinical manifestations included features of premature aging, mottled leukoderma accentuating suture lines, telangiectasia, and dryness of nasal mucosa. Pathologic changes consisted of epidermal thinning accompanied by discrete foci of lymphocyte-mediated cytotoxicity, hyperkeratosis, follicular plugging, vascular ectasia, and sclerosis beneath the epidermal layer associated with collagen type I deposition. Genomic interrogation and immunohistochemistry of sclerotic zones revealed upregulation of the AP-1 pathway components, JunB and c-Fos, previously implicated in overproduction of type I dermal collagen in the setting of systemic sclerosis. We conclude that some patients develop chronic rejection in FVCAs with striking similarities to alterations seen in certain autoimmune cutaneous disorders (lupus erythematosus and scleroderma/chronic sclerodermoid graft-versus-host disease). Identification of relevant pathways and genes, such as JunB and c-Fos, may provide new targets for preventative therapies for chronic immune-mediated changes in vascularized composite allografts.
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Registered trials
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