ArticleFrontiers in immunology2025
A comparative analysis of lesional skin, sentinel flap, and mucosal biopsies in assessing acute face transplant rejection.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Diagnostic modalities in vascularized composite allotransplantation: from histopathology to multimodal strategies.Frontiers in immunology · 2026Review
- Editorial: Methods in alloimmunity and transplantation: 2025.Frontiers in immunology · 2026Article
- Chronic Rejection in Facial Vascularized Composite Allotransplantation (fVCA).Results and problems in cell differentiation · 2026Review
- Differentiation of acute versus chronic skin rejection in a rodent model of vascularized composite allotransplantation.Frontiers in immunology · 2025Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Face transplant rejection is primarily monitored through skin biopsies, but mucosal tissue may detect immune rejection events missed by skin biopsies. Methods: We retrospectively reviewed 47 paired mucosal and facial skin biopsies and 37 paired facial skin and sentinel flap biopsies from nine face transplant recipients. Rejection was graded using the 2007 Banff classification. Correlation, sensitivity, and specificity metrics were assessed. Results: Mucosa and facial skin rejection grades correlated strongly (r = 0.72, p < 0.0001), with mucosa showing a negative predictive value (NPV) of 0.85 for facial skin rejection. Mucosal biopsies identified rejection in 10 cases missed by facial skin biopsies. Sentinel skin biopsies had high correlation but an NPV of 0.76, missing 24% of rejection cases. Conclusion: Mucosal biopsies tend to capture the full spectrum of rejection, whereas skin biopsies alone may miss important rejection events occurring in the mucosa. Mucosal biopsies should be integrated into routine monitoring alongside skin biopsies, as they not only sensitively function as sentinel tissue but also provide critical insights into rejection activity that may otherwise go undetected. This dual approach could improve overall transplant surveillance. Inconsistencies in rejection patterns between the two tissues highlight the need for a reworked grading system.
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