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Updated: Jun 2, 2026
Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation
Published on: December 30, 2025
Achievements and challenges in composite tissue allotransplantation
Stefan Schneeberger1, Luis Landin, Jerzy Jableki
1Center for Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria. stefan.schneeberger@i-med.ac.at
Insights
Over 60 limb and 16 face transplants show satisfactory outcomes. However, immunosuppression side effects and graft loss due to thrombosis, rejection, or death remain significant challenges in reconstructive surgery.
Area of Science:
- Transplantation Surgery
- Reconstructive Surgery
Background:
- Over 60 hand/forearm/arm and 16 face transplantations performed globally in the last 12 years.
- Limb and face transplantation represent advanced reconstructive surgery techniques.
Purpose of the Study:
- To summarize the European experience with hand/forearm/arm and face transplantations.
- To evaluate outcomes and identify challenges in this emerging field.
Main Methods:
- Review of European transplantation cases over the past 12 years.
- Analysis of graft survival and reasons for loss.
Main Results:
- Three graft losses reported: one due to vascular thrombosis, one to rejection/non-compliance, and one due to death.
- Overall functional and esthetic outcomes are highly satisfactory.
Conclusions:
- Despite satisfactory outcomes, serious side effects from immunosuppression pose challenges.
- Addressing immunosuppression, rejection, nerve regeneration, donor legislation, and acceptance is crucial for future progress.
Abstract:
Overall, more than 60 hand/forearm/arm transplantations and 16 face transplantations have been performed in the past 12 years. In the European experience summarized here, three grafts have been lost in response to a vascular thrombosis (n = 1), rejection and incompliance with immunosuppression (n = 1) and death (n = 1). The overall functional and esthetic outcome is very satisfactory, but serious side effects and complications related to immunosuppression are challenges hindering progress in this field. The high levels of immunosuppression, skin rejection, nerve regeneration, donor legislation and the acceptance level need to be addressed to promote growth of this promising new field in transplantation and reconstructive surgery.
