Anaesthetic Management for Face Transplantations: The Experience of Akdeniz University

Objective: Solid organ transplantation is a rescue therapy, whereas face transplantation, as well as other composite tissue allotransplantations, offers treatment options to enhance the quality of life. Difficult airway, severe haemorrhage and prolonged operative length are among the frequently enco...

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Bibliographic Details
Published in:	Turkish journal of anaesthesiology and reanimation Vol. 47; no. 3; pp. 228 - 234
Main Authors:	Hadimioglu, Necmiye, Cengiz, Melike, Ramazanoglu, Atilla, Ozkan, Ozlenen, Ertosun, Mustafa Gokhan, Bilal, Nilgun, Ozkan, Omer
Format:	Journal Article
Language:	English
Published:	Istanbul Aves Yayincilik Ltd. STI 01-06-2019 Turkish Anaesthesiology and Intensive Care Society
Subjects:	Anesthesia Original Ostomy Patients
Online Access:	Get full text
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Summary:	Objective: Solid organ transplantation is a rescue therapy, whereas face transplantation, as well as other composite tissue allotransplantations, offers treatment options to enhance the quality of life. Difficult airway, severe haemorrhage and prolonged operative length are among the frequently encountered complications of anaesthetic management in patients with a history of multiple reconstructive surgeries. Methods: Five face allotransplants that were performed in our institute, arising from four full and one partial face transplantations, were reviewed. The pitfalls encountered before, during and following surgery were then summarised. Results: Two of our patients (patients 3 and 4) underwent permanent tracheostomy preoperatively. Transplantation was initiated after surgical tracheostomy under local anaesthesia and under sedation in cases 2 and 5. Patient 1 was orally intubated without difficulty under general anaesthesia and was operated following tracheal cannulation via surgical tracheostomy. Thirteen units of red blood cells were transfused each for patients 2 and 4. Two other patients (patients 1 and 4) each received 5 units of red blood cells. Patient 5, who underwent mid-face transplantation lasting for 7.5 h, was not transfused. No major life-threatening complications were observed intraoperatively or following surgery. Conclusion: Face transplantation is a surgical procedure in which anaesthetic management may be problematic. The anaesthetist may encounter difficulties, such as difficult airway, severe bleeding, a prolonged operative time and postoperative complications. Side effects and complications may be reduced by strict follow-up and haemodynamic monitoring of patients.
ISSN:	2667-677X 2667-6370
DOI:	10.5152/TJAR.2019.04935