Vascular Composite Allograft (VCA) Donation and Transplantation Resources

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This section has been reviewed and updated as of December 2018. To see past content, click on the Archive tab below.

  • Patient Information

    Website with basic information on patient eligibility, risks and benefits, and a brief patient handbook:

    • Face Transplant Patient Information – Link
    • Hand Transplant Patient Information – Link
    • Leg Transplant Patient Information – Link
  • Resources
  • Staff Development
    • Guidance on Optimizing VCA Recovery from Deceased Donors Download – OPTN
    • Briefing Paper: Guidance on Optimizing VCA Recovery from Deceased DonorsDownload – OPTN
    • Vacularized Composit AlloTransplantationLink – Journal of The American Society of Reconstructive Transplantation
    • Vascularized Composite Tissue AllotransplantationLink – Nurse Key; T. Nicole Kelley, MS, ACNP, CCRN, CPSN, CANS, RNFA; Linda A. Evans, RN, PhD
  • Relevant Literature

    A Mobile Extracorporeal Extremity Salvage System for Replantation and Transplantation. – article – Kueckelhaus M, Fischer S, Sisk G, et al. (2016), Ann Plast Surg, 76(3): 355-60. PubMed PMID: 26808757.

    Acute rejection in vascularized composite allotransplantation.article – Fischer S, Lian CG, Kueckelhaus M, et al. (2014), Curr Opin Organ Transplant, 19(6): 531-44. Review. PubMed PMID: 25333831.

    Airway recovery after face transplantation.article – Fischer S, Wallins JS, Bueno EM, et al. (2014), Plast Reconstr Surg, 134(6): 946e-54e. PubMed PMID: 25415117.

    Attitudes regarding lower extremity allotransplantation among lower extremity amputees.article – Carty MJ, Duclos A, Talbot SG, et al. (2014)  Plast Reconstr Surg, 134(6): 1334-42. PubMed PMID: 25255108.

    Biomarker evaluation of face transplant rejection: association of donor T cells with target cell injury. – articleLian CG, Bueno EM, Granter SR, et al. (2014), Mod Pathol, 27(6): 788-99. doi: 10.1038/modpathol.2013.249. Epub 2014 Jan 17. PubMed PMID: 24434898.

    Cost analysis of conventional face reconstruction versus face transplantation for large tissue defects.article – Nguyen LL, Naunheim MR, Hevelone ND, et al. (2015), Plast Reconstr Surg, 135(1): 260-7. PubMed PMID: 25539310.

    Craniofacial Measurements of Donors and Recipients Correlate with Aesthetic Outcome in Virtual Face Transplantation. article – S Wallins J, Chandawarkar AA, Dobry A, et al. (2015), Plast Reconstr Surg Glob Open, 3(5): e385. PubMed PMID: 26090275.

    Current principles of facial allotransplantation: the Brigham and Women’s Hospital Experience.article – Pomahac B, Bueno EM, Sisk GC, et al. (2013), Plast Reconstr Surg, 131(5): 1069-76. PubMed PMID:23629089.

    Evolution of ethical debate on face transplantation.article – Kiwanuka H, Bueno EM, Diaz-Siso JR, et al. (2013), Plast Reconstr Surg, 132(6): 1558-68. Review. PubMed PMID: 24281583.

    Face time: educating face transplant candidates.article – Lamparello BM, Bueno EM, Diaz-Siso JR, et al. (2013), Eplasty, 13: e36. Print 2013. PubMed PMID: 23861990.

    Facial allotransplantation: a 3-year follow-up report.article – Diaz-Siso JR, Parker M, Bueno EM, et al. (2013), J Plast Reconstr Aesthet Surg, 66(11): 1458-63. PubMed PMID: 23911716.

    Facial and hand allotransplantation.article – Pomahac B, Gobble RM, Schneeberger S. (2014), Cold Spring Harb Perspect Med, 4(3). PubMed PMID: 24478387.

    Facial Appearance Transfer and Persistence After Three-Dimensional Virtual Face Transplantation.article – Chandawarkar AA, Diaz-Siso JR, Bueno EM, et al. (2013), Plast Reconstr Surg, [Epub ahead of print] PubMed PMID: 23783063.

    Facial restoration by transplantation: the Brigham and Women’s face transplant experience.article – Westvik TS, Dermietzel A, Pomahac B.  et al. (2015), Ann Plast Surg, Suppl 1: S2-8. PubMed PMID: 25875907.

    Facial transplantation: worth the risks? A look at evolution of indications over the last decade. article – Wo L, Bueno E, Pomahac B. (2015), Curr Opin Organ Transplant, 20(6): 615-20. PubMed PMID: 26536422.

    Follow-Up on Functional Outcomes of Face Transplantation. – article – Fischer S, Perry B, Alhefzi M, et al. (2015), Plast Reconstr Surg, 136(4 Suppl): 7-8. PubMed PMID: 26397489.

    Functional Outcomes after Bilateral Hand Transplantation: A 3.5-Year Comprehensive Follow-Up. – article – Singh M, Sisk G, Carty M, et al. (2016), Plast Reconstr Surg, 137(1): 185-9. PubMed PMID: 26710022.

    Hand transplants and the mandate for tolerance.article – Koulmanda M, Pomahac B, Fan Z, et al. (2014), Curr Opin Organ Transplant, 19(6): 545-51. Review. PubMed PMID: 25373855.

    Improving Ischemia Reperfusion Injury in Vascularized Composite Tissue Allotransplantation via Histone Deacetylase Modulation Article – (2018). [online] Available at: [Accessed 3 Dec. 2018].

    Infections following facial composite tissue allotransplantation–single center experience and review of the literature.article – Knoll BM, Hammond SP, Koo S, et al. (2013), Am J Transplant, 13(3): 770-9. PubMed PMID: 23279299.

    Ischemia-reperfusion injury in vascularized composite allotransplantation.article – Caterson EJ, Lopez J, Medina M, et al. (2013), J Craniofac Surg, 24(1): 51-6. PubMed PMID: 23321872.

    Lessons Learned from Simultaneous Face and Bilateral Hand Allotransplantation.article – Carty MJ, Hivelin M, Dumontier C, et al. (2013), Plast Reconstr Surg, [Epub ahead of print] PubMed PMID: 23584623.

    Meeting Report of the 13th Congress of the International Society of Vascularized Composite Allotransplantation Article (subscription) – Weissenbacher, A., Cendales, L., Morelon, E., et al. (2018). Transplantation, 102(8), pp.1250-1252.

    Nerve regeneration in vascularized composite allotransplantation: current strategies and future directions.Article – Leto Barone, A., Arun, A., Abt, N., Tuffaha, S. and Brandacher, G. (2015). Plastic and Aesthetic Research, 2(4), p.226.

    Noninvasive Monitoring of ImmuneRejection in Face Transplant Recipients. – article – Kueckelhaus M, Imanzadeh A, Fischer S, et al. (2015), Plast Reconstr Surg, 136(5): 1082-9. PubMed PMID: 26505709.

    Preoperative vascular mapping for facial allotransplantation: four-dimensional computed tomographic angiography versus magnetic resonance angiography.article – Soga S, Pomahac B, Mitsouras D, et al. Plast Reconstr Surg, 128(4): 883-91. PubMed PMID: 21921764.

    Reduced radiation exposure for face transplant surgical planning computed tomography angiography.article – Schultz K, George E, Mullen KM, et al. (2013), PLoS One, 8(4): e63079. doi: 10.1371/journal.pone.0063079. Print 2013. PubMed PMID: 23638180.

    Rehabilitation following hand transplantation.article – Bueno E, Benjamin MJ, Sisk G, et al. (2014), Hand (N Y), 9(1): 9-15. PubMed PMID: 24570631

    Results of a survey of organ procurement organizations to identify barriers to VCA authorization and recovery in the US Article – Cherikh, W., Harper, A., Luskin, R., Wholley, C. and McDiarmid, S. (2016). 2549. Vascularized Composite Allotransplantation, 3(1-2), pp.5-5.

    Secondary Revisions After Facial Transplantation: Optimizing Functional and Aesthetic Outcomes.article – Aycart MA, Alhefzi M, Kueckelhaus M, et al. (2015), Plast Reconstr Surg, 136(4 Suppl): 152-3. PubMed PMID: 26397686.

    Split Rejection in Vascularized Composite Allotransplantation. – article – Sinha I, Pomahac B. (2013), Eplasty, 13: e53. Review. PubMed PMID: 24244785.

    Standardizing psychosocial assessment for vascularized composite allotransplantation Article (subscription) – Jowsey-Gregoire, S. and Kumnig, M. (2016). Current Opinion in Organ Transplantation, 21(5), pp.530-535.

    Surgical Anatomy of the Whole Facial Nerve for Enabling Craniofacial and Regenerative Medicine Translational Research in Swine. – article – Aycart MA, Alhefzi M, Bueno E, et al. (2015), Reconstr Microsurg, [Epub ahead of print] PubMed PMID:26115545.

    Surgical Optimization of Motor Recovery in Face Transplantation. article – Aycart MA, Perry B, Alhefzi M, et al. (2016), J Craniofac Surg, 27(2): 286-92. doi: 10.1097/SCS.0000000000002305. PubMed PMID: 26967066.

    The advent of the restorative plastic surgeon.article – Carty MJ, Pribaz JJ, Talbot SG, et al. (2014), Plast Reconstr Surg, 133(1): 182-6. PubMed PMID: 24374677.

    The Case for Lower Extremity Allotransplantation: Lower Extremity Transplantation.article – Carty MJ, Zuker R, Cavadas P, et al. (2013), Plast Reconstr Surg, [Epub ahead of print] PubMed PMID: 23416434.

    The value of innovation: face and hand transplantation programs at Brigham and Women’s Hospital.article – Dahlborg EJ, Diaz-Siso JR, Bueno EM, et al. (2014), Plast Reconstr Surg, 134(1): 178e-179e. PubMed PMID: 25028846.

    Upper extremity composite tissue allotransplantation imaging. – article – George E, Mitsouras D, Kumamaru KK, et al. (2013), Eplasty, 13: e38. eCollection 2013. PubMed PMID: 23943677.

    Use of Video Clips to Assess the Outcomes of Bilateral Hand Transplantation. – article – Singh M, Benjamin MJ, Turenne M, et al. (2015), Plast Reconstr Surg Glob Open, 3(11): e553. PubMed PMID: 26893978.

    Utility of sentinel flaps in assessing facial allograft rejection.article – Kueckelhaus M, Fischer S, Lian CG, et al. (2015), Plast Reconstr Surg, 135(1): 250-8. PubMed PMID: 25255116.

    Vascular communications between donor and recipient tissues after successful full face transplantation.article – Kumamaru KK, Sisk GC, Mitsouras D, et al. (2014), Am J Transplant, 14(3): 711-9. PubMed PMID: 24502329.

    Vascularized composite allotransplantation and tissue engineering.article – Bueno EM, Diaz-Siso JR, Sisk GC, et al. (2013), Craniofac Surg, 24(1): 256-63. PubMed PMID: 23348296.

    Vascularized composite allotransplantation: current standards and novel approaches to prevent acute rejection and chronic allograft deterioration. article – Kueckelhaus M, Fischer S, Seyda M, et al. (2015), Transpl Int, PubMed PMID: 26265179.

    Vascularized composite tissue allotransplantation – state of the art.article – Diaz-Siso JR, Bueno EM, Sisk GC, et al. (2013), Clin Transplant, 27(3): 330-7. Epub 2013 Apr 14. PubMed PMID: 23581799.

    Vascularized composite allotransplantation in the United States: A descriptive analysis of the Organ Procurement and Transplantation Network Data Article (subscription) – Cherikh, W., Cendales, L., Wholley, C., Wainright, J., et al. (2018). American Journal of Transplantation.

  • Archive

    A Position Paper in Support of Face Transplantation in the Blind.article – Carty MJ, Bueno EM, Soleymani Lehmann L, et al. (2012), Plast Reconstr Surg, 130(2): 319-24 PubMed PMID: 22495209.

    A position paper in support of hand transplantation in the blind.article – Carty MJ, Bueno E, Lehmann LS, et al. (2011), Plast Reconstr Surg, 128(5): 510e-515e. Review. PubMed PMID: 22030511.

    Brief Report: Perioperative Management of Face Transplantation: A Survey.article – Edrich T, Cywinski JB, Colomina MJ, et al. (2012), AnesthAnalg, 115(3): 668-70 PubMed PMID: 22523417.

    Cine computed tomography angiography evaluation of blood flow for full face transplant surgical planning.article – Sisk GC, Kumamaru KK, Schultz K, et al. (2012), Eplasty, 12: e57. Epub 2012 Dec 18. PubMed PMID: 23308304.

    Composite tissue transplantation: a new era in transplantation surgery.article – Pomahac B, Aflaki P.  (2010), Eplasty, 10. pii: e58. PubMed PMID: 20862294; PubMed Central PMCID: PMC2941187.

    Craniofacial Principles in Face Transplantation.article – Caterson EJ, Diaz-Siso JR, Shetye P, et al. (2012), J Craniofac Surg, 23(5): 1234-8 PubMed PMID: 22948648.

    CT Angiography for Surgical Planning in Face Transplantation Candidates.article – Soga S, Pomahac B, Wake N, et al. (2012), AJNR Am J Neuroradiol, [Epub ahead of print] PubMed PMID: 22878008.

    Donor facial composite allograft recovery operation: Cleveland and Boston experiences.article – Pomahac B, Papay F, Bueno EM, et al. (2012), Plast Reconstr Surg, 129(3): 461e-467e. PubMed PMID: 22373994.

    Establishing a composite tissue allotransplantation program.article – Pomahac B. (2012), J Reconstr Microsurgery, 28(1): 3-6. Epub 2011 Aug 2. PubMed PMID: 21811966.

    Evaluation of appearance transfer and persistence in central face transplantation: a computer simulation analysis.article – Pomahac B, Aflaki P, Nelson C, et al. (2010), J Plast Reconstr Aesthet Surg, 63(5): 733-8. Epub 2009 Apr 23. PubMed PMID: 19398394.

    Face transplantation.article – Pomahac B, Nowinski D, Diaz-Siso JR, et al. (2011), Curr Probl Surg, 48(5): 293-357. Review. PubMed PMID: 21463717.

    Facial composite tissue allograft.article – Pomahac B, Pribaz J. (2012), J Craniofac Surg, 23(1): 265-7. PubMed PMID: 22337422.

    Noninvasive vascular images for face transplant surgical planning.article – Soga S, Wake N, Bueno EM, et al. (2011), Eplasty, 11: e51. Epub 2011 Dec 14. PubMed PMID: 22184509; PubMed Central PMCID: PMC3240129.

    Novel Surgical Technique for Full Face Transplantation.article – Pomahac B, Pribaz JJ, Bueno EM, et al. (2012), Plast Reconstr Surg, 130(3): 549-55 PubMed PMID: 22575856.

    Perioperative management of partial face transplantation involving a heparin antibody-positive donor.article – Edrich T, Pomahac B, Lu JT, et al. (2011), J Clin Anesth, 23(4): 318-21. PubMed PMID: 21663819.

    Psychosocial Changes 6 Months after Face Transplantation. Psychosomatics.article – Chang G, Pomahac B. (2012), [Epub ahead of print] PubMed PMID: 23194929

    Simulated central face transplantation: age consideration in matching donors and recipients.article – Aflaki P, Nelson C, Balas B, et al. (2010), J Plast Reconstr Aesthet Surg, 63(3): e283-5. Epub 2009 Sep 13. PubMed PMID: 19748842.

    Surgical planning for composite tissue allotransplantation of the face using 320-detector row computed tomography. – article – Soga S, Ersoy H, Mitsouras D, et al. (2010), J Comput Assist Tomogr, 34(5): 766-9. PubMed PMID: 20861783.

    The Brigham and Women’s Hospital face transplant program: a look back.article – Singhal D, Pribaz JJ, Pomahac B. (2012), Plast Reconstr Surg, 129(1): 81e-88e. PubMed PMID: 22186587.

    Three patients with full facial transplantation.article – Pomahac B, Pribaz J, Eriksson E, et al. (2012), N Engl J Med, 366(8): 715-22. Epub 2011 Dec 28. PubMed PMID: 22204672.

    Vascular considerations in composite midfacial allotransplantation.article – Pomahac B, Lengele B, Ridgway EB, et al. (2010), Plast Reconstr Surg, 125(2): 517-22. PubMed PMID: 19910848.