Living related hemi-face skin transplant using radial forearm free flap for a xeroderma pigmentosa patient: early outcome

详细信息    查看全文

• 作者：Ayman Amin (1)
  Mahmoud Bassiouny (1)
  Kareem Sallam (1)
  Galal Ghally (1)
  Hanaa El-Karaksy (2)
  Alaa El-Haddad (3)
  
• 刊名：Head & Neck Oncology
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：2
• 期：1
• 全文大小：1764KB
• 参考文献：1. Bristow R, Harrington L: Genomic Stability and DNA repair. In / The Basic science of Oncology. Edited by: Tannock I, et al. McGraw Hill. USA; 2005:80.
  2. Adeson T, Begg M: Xeroderma pigmentosum of mild type. / Br J Dermatol 1950, 62:402鈥?. CrossRef
  3. Bristow R, Harrington L: Genomic Stability and DNA repair. In / The Basic science of Oncology. Edited by: Tannock I, et al. McGraw Hill. USA; 2005:84f.
  4. Neel V, Sober A: Other Skin Cancers. In / Cancer medicine. Edited by: Holland J, Frei E. BC Decker. Spain; 2003:2000.
  5. Schwartz M, Konstadoulakis M, Roayaie S: Recurrence of hepatocellular carcinoma after liver transplantation: Is immunosuppression a factor? / Liver transplantation 2005,11(5):494鈥?96. CrossRef
  6. Zahid S, Brownell I: Repairing DNA damage in xeroderma pigmentosum: T4N5 lotion and gene therapy. / J Drugs Dermatol 2008,7(4):405鈥?.
  7. Diwan A: Xeroderma Pigmentosum: Treatment & Medication. / eMedicine Specialties, dermatology 2008.
  8. Yarosh D, Klein J, O'Connor A, Hawk J, Rafal E, Wolf P: Effect of topically applied T4 endonuclease V in liposomes on skin cancer in xeroderma pigmentosum: a randomised study. Xeroderma Pigmentosum Study Group. / Lancet 2001,357(9260):926鈥?. CrossRef
  9. Akan I, Ozdemir R, Sungur N, Ulusoy M: Combined treatment of xeroderma pigmentosum with full-face chemijcal peeling and dermabrasion. / Eur J Plast Surg 2001, 24:243鈥?6. CrossRef
  10. Allen RJ Jr, LoTempio MM, Craigie JE, Allen RJ Sr: Transplantation in identical twins: another option for breast reconstruction. / Plast Reconstr Surg 2008,122(4):1019鈥?3. CrossRef
  11. Valauri FA, Buncke HJ, Alpert BS, Lineaweaver WC, Argenta LC: Microvascular transplantation of expanded free scalp flaps between identical twins. In / Plast Reconstr Surg Edited by: Valauri FA, Buncke HJ, Alpert BS, Lineaweaver WC, Argenta LC. 1990,85(3):432鈥?. CrossRef
  12. Hivelin M, Siemionow M, Grimbert P, Lantieri L: Extracorporeal photopheresis: From solid organs to face transplantation. / Transpl Immunol 2009,21(3):117鈥?8. CrossRef
  13. Devauchelle B, Badet L, Lengel茅 B, Morelon E, Testelin S, Michallet M, D'Hauthuille C, Dubernard JM: First human face allograft: early report. / Lancet 2006,368(9531):203鈥?. CrossRef
  14. Dubernard JM, Lengele' B, Moreolon E, Testelin S, Badet L, / et al.: Outcomes 18 months after first human face transplant. / N Engl J Med 2007, 357:2451鈥?0. CrossRef
  15. Guo S, Han Y, Zhang X, Lu B, Yi C, Zhang H, Ma X, Wang D, Yang L, Fan X, Liu Y, Lu K, Li H: Human facial allotransplantation: a 2-year follow-up study. / Lancet 2008, 372:603鈥?. CrossRef
  16. Siemionow MZ, Papay F, Djohan R, Bernard S, Gordon CR, Alam D, Hendrickson M, Lohman R, Eghtesad B, Fung J: First U.S. near total human face transplantation: a paradigm shift for massive complex injuries. / Plast Reconstr Surg 2010,125(1):111鈥?2. CrossRef
  
• 作者单位：Ayman Amin (1)
  Mahmoud Bassiouny (1)
  Kareem Sallam (1)
  Galal Ghally (1)
  Hanaa El-Karaksy (2)
  Alaa El-Haddad (3)
  
  1. Surgical oncology department, national cancer instituite, Cairo, Egypt
  2. Pediatrics department, kasr El-eini school of medicine, Cairo, Egypt
  3. Paediaric oncology department, national cancer instituite, Cairo, Egypt
  

文摘

Introduction Xeroderma pigmentosa (XP) is a hereditary disease characterized by deficient repair of DNA damage that occurred on exposure of the skin to ultraviolet irradiation. The affected children have a propensity to develop multiple skin cancers mainly in the face and eventually die before the age of 20. Hypothesis Allograft replacement of facial skin by a healthy skin from normal person might decrease the incidence of skin cancer development, the number of surgical procedures, and eventually might improve the survival of these miserable patients. Methods As Cadaveric organs are unavailable in our country. After approval from the ethical committee, confirmed agreement of the donor and the patient's guardian, a radial forearm free flap was transplanted from an ABO compatible mother to her 5 year old daughter with XP. The mother had an older daughter died from the same disease at the age of 14. The flap replaced skin of the hemi face that developed precancerous lesions. The girl was kept on adjusted doses of immunosuppressive drugs. Results The flap survived, wounds healed uneventfully. The flap developed a reddish spot one and half month following transplant where baseline skin biopsy was taken. In the fifth months the girl presented with bad non salvageable rejection that ended up loosing the flap. On long term follow up, the girl started to develop skin lesion on the virgin half of the face. Our early cosmetic result replacing half of the facial skin was very promising. In addition the girl did not develop skin lesions in the operated site. Conclusion Our early cosmetic result was very promising. In addition to this, the girl did not develop skin lesions in the operated side of the face