Transmission of rosacea from the graft in facial allotransplantation.

  • Jean Kanitakis
  • Published 2011 in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

Abstract

Composite tissue allotransplantation (CTA) is emerging as an active area of clinical research for the replacement of nonvital body parts missing usually because of severe injuries. As with other organ transplants, CTA may transmit donor-hosted diseases to their recipients. Conceivably, infectious agents present in the skin or other CTA tissues are able to reach the recipient’s tissues via the bloodstream and to produce systemic infections, favored by the immunosuppressive treatment. The first patient with a facial allograft (FA) developed herpes simplex (HSV) labialis at least on two occasions, both of which were followed by episodes of graft rejection. Since HSV is considered to reside in the lymph nodes wherefrom it spreads to the skin, the donor-skin origin of these infections is however questionable. The patient developed later mollusca contagiosa, benign skin growths due to a poxvirus; these were also most likely not donor-transmitted, since the allograft was healthy at the time of recovery (1). The possibility of tumor transmission from CTA exists, although it has not been observed so far. Although this possibility is not very likely, it underscores the necessity of prevention by careful donor screening. The issue of ‘transmission’ of inflammatory skin diseases (ISD) is more subtle, although pathogenetically very interesting. ISDmostly develop from the interaction between resident skin cells with circulating immune-competent cells or antibodies of recipient’s

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