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Lancet：面部移植手术长期结果

2016-08-25 fsy 译 MedSci原创

面部移植手术
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从2005年开始，全世界共有超过30例患者接受了面部移植手术，但目前还没有文献报道记录长期随访结果。

从2005年开始，全世界共有超过30例患者接受了面部移植手术，但目前还没有文献报道记录这些患者的长期随访结果。研究人员试图调查面部移植的长期风险和益处。

在这项单中心，前瞻性，开放性研究中，研究人员评估了20例面部有瑕疵的患者。筛选出10例患者后，3例患者被排除，剩余7例患者接受移植：两例患者有神经纤维瘤病1型，1例患者面部烧伤，四例患者有自己造成的面部枪伤。研究人员在移植后平均6年（3.4-9年）后报告了6例异体移植受者的长期结果。除了计划修订和免疫抑制后续治疗，所有入院治疗的患者都报告了不良事件（安全性终点）。研究人员前瞻性收集了预定义的免疫，代谢，手术和社会融合终点。患者通过简明健康调查问卷(SF-36)进行了定量健康相关的生活质量评估。

在七例患者中，两粒患者死亡：1例由于假单胞菌感导致的移植破坏在65天时死亡，第二例在移植3.4年后自杀死亡。6例幸存患者在长期随访过程中有功能移植。在第一个月时安全性终点与感染有关，移植后第1天至7天有急性排斥，或发生免疫抑制治疗的副作用。在最后随访时，所有患者都使用高剂量的类固醇进行复发性排斥合理的维持治疗，但没有患者发展为糖尿病。三例患者患高血压，有一例患者需要进行治疗。所有患者肾小球滤过率明显减少。所有移植受者和他们的家人都接受了他们的移植。患者的社会融合和生活质量的改善是高度可变的，依赖于基线水平和精神合并症。

这些长期结果显示，患者的社会支持和预先存在的精神状况都对面部移植的风险-收益比有关键作用。在严格的伦理审查委员会的控制下，周密的术前患者选择和长期的术后随访方案应该被用于未来这种类型的移植。

原始出处：

Laurent Lantieri,Philippe Grimbert,Nicolas Ortonne，et al.Face transplant: long-term follow-up and results of a prospective open study,Lancet,2016.8.25

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    2017-06-11 虈亣靌

    学习了，受益匪浅。

    0

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    2017-07-14 zhucaizhong7777

    #长期结果#

    0

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    2016-12-12 虈亣靌

    学习了，长见识了

    0

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    2016-11-30 虈亣靌

    讲的好，学习了

    0

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    2017-07-24 howi

    #Lancet#

    0

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    2016-11-14 虈亣靌

    讲得好，分享

    0

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    2016-11-04 往日如昨

    学习中，谢谢

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=209311, encodeId=f453209311b7, content=学习了，受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jun 11 08:47:44 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723753, encodeId=b7661e2375347, content=<a href='/topic/show?id=ac899e0343c' target=_blank style='color:#2F92EE;'>#长期结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97034, encryptionId=ac899e0343c, topicName=长期结果)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee6a33536665, createdName=zhucaizhong7777, createdTime=Fri Jul 14 19:20:00 CST 2017, time=2017-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162200, encodeId=9ff8162200e6, content=学习了，长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Dec 12 15:49:35 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159180, encodeId=b0b4159180e2, content=讲的好，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 30 13:44:24 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1828583, encodeId=eab71828583b3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jul 24 08:20:00 CST 2017, time=2017-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155701, encodeId=9670155e016d, content=讲得好，分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Nov 14 14:04:48 CST 2016, time=2016-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153346, encodeId=61f61533466c, content=学习中，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:42:07 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153345, encodeId=e756153345fb, content=学习了，继续加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:41:42 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153344, encodeId=85cb15334422, content=面部整形要求很高，难度大, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:41:21 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153343, encodeId=99f91533432a, content=继续学习，文章真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:39:42 CST 2016, time=2016-11-04, status=1, ipAttribution=)]
    2016-11-04 往日如昨

    学习了，继续加油

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=209311, encodeId=f453209311b7, content=学习了，受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jun 11 08:47:44 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723753, encodeId=b7661e2375347, content=<a href='/topic/show?id=ac899e0343c' target=_blank style='color:#2F92EE;'>#长期结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97034, encryptionId=ac899e0343c, topicName=长期结果)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee6a33536665, createdName=zhucaizhong7777, createdTime=Fri Jul 14 19:20:00 CST 2017, time=2017-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162200, encodeId=9ff8162200e6, content=学习了，长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Dec 12 15:49:35 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159180, encodeId=b0b4159180e2, content=讲的好，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 30 13:44:24 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1828583, encodeId=eab71828583b3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jul 24 08:20:00 CST 2017, time=2017-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155701, encodeId=9670155e016d, content=讲得好，分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Nov 14 14:04:48 CST 2016, time=2016-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153346, encodeId=61f61533466c, content=学习中，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:42:07 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153345, encodeId=e756153345fb, content=学习了，继续加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:41:42 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153344, encodeId=85cb15334422, content=面部整形要求很高，难度大, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:41:21 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153343, encodeId=99f91533432a, content=继续学习，文章真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:39:42 CST 2016, time=2016-11-04, status=1, ipAttribution=)]
    2016-11-04 往日如昨

    面部整形要求很高，难度大

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=209311, encodeId=f453209311b7, content=学习了，受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jun 11 08:47:44 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723753, encodeId=b7661e2375347, content=<a href='/topic/show?id=ac899e0343c' target=_blank style='color:#2F92EE;'>#长期结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97034, encryptionId=ac899e0343c, topicName=长期结果)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee6a33536665, createdName=zhucaizhong7777, createdTime=Fri Jul 14 19:20:00 CST 2017, time=2017-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162200, encodeId=9ff8162200e6, content=学习了，长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Dec 12 15:49:35 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159180, encodeId=b0b4159180e2, content=讲的好，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 30 13:44:24 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1828583, encodeId=eab71828583b3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jul 24 08:20:00 CST 2017, time=2017-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155701, encodeId=9670155e016d, content=讲得好，分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Nov 14 14:04:48 CST 2016, time=2016-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153346, encodeId=61f61533466c, content=学习中，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:42:07 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153345, encodeId=e756153345fb, content=学习了，继续加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:41:42 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153344, encodeId=85cb15334422, content=面部整形要求很高，难度大, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:41:21 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153343, encodeId=99f91533432a, content=继续学习，文章真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Fri Nov 04 12:39:42 CST 2016, time=2016-11-04, status=1, ipAttribution=)]
    2016-11-04 往日如昨

    继续学习，文章真好

    0

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