New insights into facial transplantation

January 17, 2014

In 2009, the first face transplant was performed at Brigham and Women's Hospital (BWH), and lead surgeon, Dr. Bohdan Pomahac has been pioneering the procedure since. However, understanding the technical challenges, particularly around how the recipient accepts or rejects the donated face, is just beginning. Following any transplant, including facial transplant, T cells in the recipient mount an immune response to the donated tissue, threatening rejection. This process is successfully managed through immunosupression medication so that the recipient is able to tolerate the transplanted face. Now, researchers at BWH have made a discovery that provides new insight into the body's rejection process. Researchers have demonstrated that immune cells, or T cells, involved in the rejection process are significantly of donor origin. These findings are published in Modern Pathology on January 17, 2014.

"The conventional belief about was that rejection is directly related to the recipient T cells attacking the donor T cells of the face, which are perceived as foreign to the recipient's immune system," explained Christine Lian, MD, a skin pathologist at BWH and lead author of this study. "We now need to rethink this process. Based on our findings, it is clear that the donor T cells, which are transferred as part of the new face, play a significant role in the rejection process as well."

The researchers examined 131 face transplant biopsy specimens from a total of five patients who received a face transplant between 2009 and 2013 at BWH. The samples were examined by conventional microscopy for categorizing the level of rejection and guiding immunosuppressant therapy, and additional antibody based biomarkers were also applied. The use of biomarkers allowed the researchers to differentiate between the donor and recipient cells under the microscope. Researchers found that during active rejection episodes, many to most of the in the face specimens that were involved in the rejection were of donor origin.

"The participation of these donor immune cells in face transplant rejection represents a paradigm shift in the understanding of the rejection process," explained George F. Murphy, MD, director of Dermatopathology at BWH and a senior author of this study. "One intriguing possibility that now exists is that the transplanted faces are not simply passive targets vulnerable to rejection, but carry along with them their own army of immune cells that may defend the face against attacking recipient cells in order to thwart the rejection process," says Murphy.

Researchers note that more studies need to be done to better understand these complex immune cell interactions, but these new findings will help to develop the best diagnostic and therapeutic strategies that, for the first time, will consider include immune cells from the as well as the recipient.

Explore further: Taking rejection out of organ transplant operations

Related Stories

Taking rejection out of organ transplant operations

July 31, 2013
Organ transplant operations save lives. But for recipients, treatment does not end with an operation - they must take medication for the rest of their lives.

New research could expand availability of hand, face transplants

January 9, 2014
Massachusetts General Hospital (MGH) investigators have made an important step towards greater availability of hand transplants, face transplants and other transplants involving multiple types of tissue. In their report in ...

Transplant experts challenge assumption, describe pathway that leads to organ rejection

May 15, 2013
Transplant researchers at the University of Pittsburgh School of Medicine challenge a long-held assumption about how biologic pathways trigger immune system rejection of donor organs in a report published online today in ...

Dendritic cell therapy improves kidney transplant survival, study says

June 28, 2013
(Medical Xpress)—A single systemic dose of special immune cells prevented rejection for almost four months in a preclinical animal model of kidney transplantation, according to experts at the University of Pittsburgh School ...

Promising breakthrough for transplant patients

February 27, 2013
A team led by Dr. Marie-Josée Hébert from the University of Montreal Hospital Research Centre (CRCHUM) has discovered a new cause of organ rejection in some kidney transplant patients. Her team has identified a new class ...

Study identifies potential new strategy to improve odds of corneal transplant acceptance

December 30, 2013
For the estimated 10 percent of patients whose bodies reject a corneal transplant, the odds of a second transplant succeeding are poor. All that could change, however, based on a UT Southwestern Medical Center study that ...

Recommended for you

Want to win at sports? Take a cue from these mighty mice

July 20, 2017
As student athletes hit training fields this summer to gain the competitive edge, a new study shows how the experiences of a tiny mouse can put them on the path to winning.

'Smart' robot technology could give stroke rehab a boost

July 19, 2017
Scientists say they have developed a "smart" robotic harness that might make it easier for people to learn to walk again after a stroke or spinal cord injury.

Engineered liver tissue expands after transplant

July 19, 2017
Many diseases, including cirrhosis and hepatitis, can lead to liver failure. More than 17,000 Americans suffering from these diseases are now waiting for liver transplants, but significantly fewer livers are available.

Lunatic Fringe gene plays key role in the renewable brain

July 19, 2017
The discovery that the brain can generate new cells - about 700 new neurons each day - has triggered investigations to uncover how this process is regulated. Researchers at Baylor College of Medicine and Jan and Dan Duncan ...

New animal models for hepatitis C could pave the way for a vaccine

July 19, 2017
They say that an ounce of prevention is worth a pound of cure. In the case of hepatitis C—a disease that affects nearly 71 million people worldwide, causing cirrhosis and liver cancer if left untreated—it might be worth ...

Omega-3 fatty acids fight inflammation via cannabinoids

July 18, 2017
Chemical compounds called cannabinoids are found in marijuana and also are produced naturally in the body from omega-3 fatty acids. A well-known cannabinoid in marijuana, tetrahydrocannabinol, is responsible for some of its ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.