My friends and colleagues, Drs. Risal Djohan and Robert Lohman, were lead surgeons who helped perform this monumental operation today at the Cleveland Clinic. They are to be congratulated for putting together a great team of surgeons and taking this huge step in “Composite Tissue Allotransplantation.” How is this different from “solid organ” transplantation? Not very different at all.
Most people do not know the history of Transplantation and that Plastic Surgeons have been at the forefront of this area since the beginning. These concepts have grown from skin grafts, to organs, and now to “composite tissue”–face, hands, limbs, etc. This is the new era of reconstructive plastic surgery: with Microsurgery–reconnecting small blood vessels and nerves–all of this is possible.
The question for a long time has been “Can we peform a facial or hand transplantation?” The answer for the past 20 years has been, “yes.” We can and have been able to technically “replant” an amputed hand and facial part, the question now has become, “Should we do this?” The simple answer of course is “yes.” There are many patients who would benefit from these types of procedures. However, the issues with long-term immunosuppression that can potentially cause many disease processes is still the critical issue in performing these kinds of operations. The holy Grail is still at large. When the immunosuppression issue falls to the background, this is when composite tissue allotransplantation will no longer make headlines, but become a routine surgery, just as plastic surgeons performing reconstructive microsurgery to reconstruct limbs and cancer defects, is done on a daily basis.