Noninvasive monitoring of immune rejection in face transplant recipients

Maximilian Kueckelhaus, Amir Imanzadeh, Sebastian Fischer, Kanako Kumamaru, Muayyad Alhefzi, Ericka Bueno, Nicole Wake, Marie D. Gerhard-Herman, Frank J. Rybicki, Bohdan Pomahac

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Chronic rejection leading to allograft loss remains a significant concern after facial allotransplantation. Chronic rejection may occur without clinical signs or symptoms. The current means of monitoring is histologic analyses of allograft biopsy specimens, which is both invasive and impractical. Prior data suggest that chronic rejection is associated with changes in intima and media thickness of vessels in arms and solid organ allografts; such data have not been published for face transplant recipients. Methods: The authors used a 48-MHz transducer to acquire images of the bilateral facial, radial, dorsalis pedis and, if applicable, sentinel flap arteries in five face transplant recipients (8 months to 4.5 years after transplantation) and five control subjects. The authors assessed the intima, media, and adventitia thickness plus lumen and the total vessel diameter and area. Results: Face transplant recipients had thicker intima in all sites compared with controls, but the ratio of the intimal thickness of facial and radial arteries was similar in face transplant recipients compared with controls (1.00 versus 0.95; p = 0.742). Intraobserver correlation showed reliable reproducibility of the measurements (r = 0.935, p ≥ 0.001). Interobserver correlation demonstrated reproducibility of intima measurements (r = 0.422, p ≥ 0.001). Conclusion: The authors demonstrate that ultrasound biomicroscopy is feasible for postsurgical monitoring, and have developed a new benchmark parameter, the facial arterÿCtöCradial artery intimal thickness ratio, to be used in future testing in the setting of chronic rejection.

Original languageEnglish (US)
Pages (from-to)1082-1089
Number of pages8
JournalPlastic and reconstructive surgery
Volume136
Issue number5
DOIs
StatePublished - Oct 27 2015
Externally publishedYes

Fingerprint

Facial Transplantation
Immunologic Monitoring
Tunica Intima
Allografts
Arteries
Acoustic Microscopy
Benchmarking
Adventitia
Radial Artery
Transducers
Signs and Symptoms
Arm
Transplantation
Biopsy
Transplant Recipients

ASJC Scopus subject areas

  • Surgery

Cite this

Kueckelhaus, M., Imanzadeh, A., Fischer, S., Kumamaru, K., Alhefzi, M., Bueno, E., ... Pomahac, B. (2015). Noninvasive monitoring of immune rejection in face transplant recipients. Plastic and reconstructive surgery, 136(5), 1082-1089. https://doi.org/10.1097/PRS.0000000000001703

Noninvasive monitoring of immune rejection in face transplant recipients. / Kueckelhaus, Maximilian; Imanzadeh, Amir; Fischer, Sebastian; Kumamaru, Kanako; Alhefzi, Muayyad; Bueno, Ericka; Wake, Nicole; Gerhard-Herman, Marie D.; Rybicki, Frank J.; Pomahac, Bohdan.

In: Plastic and reconstructive surgery, Vol. 136, No. 5, 27.10.2015, p. 1082-1089.

Research output: Contribution to journalArticle

Kueckelhaus, M, Imanzadeh, A, Fischer, S, Kumamaru, K, Alhefzi, M, Bueno, E, Wake, N, Gerhard-Herman, MD, Rybicki, FJ & Pomahac, B 2015, 'Noninvasive monitoring of immune rejection in face transplant recipients', Plastic and reconstructive surgery, vol. 136, no. 5, pp. 1082-1089. https://doi.org/10.1097/PRS.0000000000001703
Kueckelhaus M, Imanzadeh A, Fischer S, Kumamaru K, Alhefzi M, Bueno E et al. Noninvasive monitoring of immune rejection in face transplant recipients. Plastic and reconstructive surgery. 2015 Oct 27;136(5):1082-1089. https://doi.org/10.1097/PRS.0000000000001703
Kueckelhaus, Maximilian ; Imanzadeh, Amir ; Fischer, Sebastian ; Kumamaru, Kanako ; Alhefzi, Muayyad ; Bueno, Ericka ; Wake, Nicole ; Gerhard-Herman, Marie D. ; Rybicki, Frank J. ; Pomahac, Bohdan. / Noninvasive monitoring of immune rejection in face transplant recipients. In: Plastic and reconstructive surgery. 2015 ; Vol. 136, No. 5. pp. 1082-1089.
@article{c7bf9cc8d90f466195cb4b4f0b4c5063,
title = "Noninvasive monitoring of immune rejection in face transplant recipients",
abstract = "Background: Chronic rejection leading to allograft loss remains a significant concern after facial allotransplantation. Chronic rejection may occur without clinical signs or symptoms. The current means of monitoring is histologic analyses of allograft biopsy specimens, which is both invasive and impractical. Prior data suggest that chronic rejection is associated with changes in intima and media thickness of vessels in arms and solid organ allografts; such data have not been published for face transplant recipients. Methods: The authors used a 48-MHz transducer to acquire images of the bilateral facial, radial, dorsalis pedis and, if applicable, sentinel flap arteries in five face transplant recipients (8 months to 4.5 years after transplantation) and five control subjects. The authors assessed the intima, media, and adventitia thickness plus lumen and the total vessel diameter and area. Results: Face transplant recipients had thicker intima in all sites compared with controls, but the ratio of the intimal thickness of facial and radial arteries was similar in face transplant recipients compared with controls (1.00 versus 0.95; p = 0.742). Intraobserver correlation showed reliable reproducibility of the measurements (r = 0.935, p ≥ 0.001). Interobserver correlation demonstrated reproducibility of intima measurements (r = 0.422, p ≥ 0.001). Conclusion: The authors demonstrate that ultrasound biomicroscopy is feasible for postsurgical monitoring, and have developed a new benchmark parameter, the facial arter{\"y}Ct{\"o}Cradial artery intimal thickness ratio, to be used in future testing in the setting of chronic rejection.",
author = "Maximilian Kueckelhaus and Amir Imanzadeh and Sebastian Fischer and Kanako Kumamaru and Muayyad Alhefzi and Ericka Bueno and Nicole Wake and Gerhard-Herman, {Marie D.} and Rybicki, {Frank J.} and Bohdan Pomahac",
year = "2015",
month = "10",
day = "27",
doi = "10.1097/PRS.0000000000001703",
language = "English (US)",
volume = "136",
pages = "1082--1089",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Noninvasive monitoring of immune rejection in face transplant recipients

AU - Kueckelhaus, Maximilian

AU - Imanzadeh, Amir

AU - Fischer, Sebastian

AU - Kumamaru, Kanako

AU - Alhefzi, Muayyad

AU - Bueno, Ericka

AU - Wake, Nicole

AU - Gerhard-Herman, Marie D.

AU - Rybicki, Frank J.

AU - Pomahac, Bohdan

PY - 2015/10/27

Y1 - 2015/10/27

N2 - Background: Chronic rejection leading to allograft loss remains a significant concern after facial allotransplantation. Chronic rejection may occur without clinical signs or symptoms. The current means of monitoring is histologic analyses of allograft biopsy specimens, which is both invasive and impractical. Prior data suggest that chronic rejection is associated with changes in intima and media thickness of vessels in arms and solid organ allografts; such data have not been published for face transplant recipients. Methods: The authors used a 48-MHz transducer to acquire images of the bilateral facial, radial, dorsalis pedis and, if applicable, sentinel flap arteries in five face transplant recipients (8 months to 4.5 years after transplantation) and five control subjects. The authors assessed the intima, media, and adventitia thickness plus lumen and the total vessel diameter and area. Results: Face transplant recipients had thicker intima in all sites compared with controls, but the ratio of the intimal thickness of facial and radial arteries was similar in face transplant recipients compared with controls (1.00 versus 0.95; p = 0.742). Intraobserver correlation showed reliable reproducibility of the measurements (r = 0.935, p ≥ 0.001). Interobserver correlation demonstrated reproducibility of intima measurements (r = 0.422, p ≥ 0.001). Conclusion: The authors demonstrate that ultrasound biomicroscopy is feasible for postsurgical monitoring, and have developed a new benchmark parameter, the facial arterÿCtöCradial artery intimal thickness ratio, to be used in future testing in the setting of chronic rejection.

AB - Background: Chronic rejection leading to allograft loss remains a significant concern after facial allotransplantation. Chronic rejection may occur without clinical signs or symptoms. The current means of monitoring is histologic analyses of allograft biopsy specimens, which is both invasive and impractical. Prior data suggest that chronic rejection is associated with changes in intima and media thickness of vessels in arms and solid organ allografts; such data have not been published for face transplant recipients. Methods: The authors used a 48-MHz transducer to acquire images of the bilateral facial, radial, dorsalis pedis and, if applicable, sentinel flap arteries in five face transplant recipients (8 months to 4.5 years after transplantation) and five control subjects. The authors assessed the intima, media, and adventitia thickness plus lumen and the total vessel diameter and area. Results: Face transplant recipients had thicker intima in all sites compared with controls, but the ratio of the intimal thickness of facial and radial arteries was similar in face transplant recipients compared with controls (1.00 versus 0.95; p = 0.742). Intraobserver correlation showed reliable reproducibility of the measurements (r = 0.935, p ≥ 0.001). Interobserver correlation demonstrated reproducibility of intima measurements (r = 0.422, p ≥ 0.001). Conclusion: The authors demonstrate that ultrasound biomicroscopy is feasible for postsurgical monitoring, and have developed a new benchmark parameter, the facial arterÿCtöCradial artery intimal thickness ratio, to be used in future testing in the setting of chronic rejection.

UR - http://www.scopus.com/inward/record.url?scp=84945905887&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945905887&partnerID=8YFLogxK

U2 - 10.1097/PRS.0000000000001703

DO - 10.1097/PRS.0000000000001703

M3 - Article

C2 - 26505709

AN - SCOPUS:84945905887

VL - 136

SP - 1082

EP - 1089

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 5

ER -