CONSERVATION AEROBIE DES ORGANES (DEVELOPPEMENT D'UN MODELE DE BLOC MULTI-VISCERAL POUR L'ETUDE D'UNE EMULSION DE FLUOROCARBURE)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Facial Allotransplantation, Looking for the Future

International audienceIs it surprising that in more than10 years only less than40 face allotransplants have been realized? What are the lessons from that reality? The first ethical debate led in 2004 by the national ethical committee (article 82) is not exactly in the same purpose: face transplant could lead to death issue (5 cases out of the series of 38 transplanted patients). This dimension which is not only linked on the immunosuppressive regimen should be mentioned. That could explain this. The fourth dimension, the time one intervenes at two stages -the behavior of the transplant tissues themselves along the time in comparison with the other tissues -the risks for chronic rejection which is too early distanciate The average on organ transplant length life is about 15 years that leads to put the question of second transplantation on. Without deny the successful breakthrough of this first face transplant which was not only a new hope but also a hermeneutic scope, our whole works should be led to go beyond and if we could not enfranchise ourselves of our immunologic identity, we should completely involve the regenerative surger

Face Transplant: Extrapolation to Children and Teenagers

International audienceIf there is without any contest a place for face transplant in adults despite the real status of the first 35 realised ones, it is not so obvious that face transplant could be so clearly extrapoled to children. The question is not surgical. It is related to the pathologies themselves for which transplant could be suitable. Moreover the procurement of face transplant will be more difficult because of immunologic criteria but also age and photo type. Specificity of the newborn malformative face is usually not only a question of tissue defect. It is reasonably not an indication for VCA. It should be added that nothing is known about the future of transplantation in terms of duration but also morbidities due to immunosuppression. Indications critera are rather negative. To raise the question of VCA for children has a double benefit. The first is to point out that surgical innovation oftenly arise from a non-imaginable or non-imagined clinical situation. The second is the question of VCA in newborn regarding the tolerance

Premalignant and Malignant Skin Lesions in Two Recipients of Vascularized Composite Tissue Allografts (Face, Hands)

Recipients of solid organ transplants (RSOT) have a highly increased risk for developing cutaneous premalignant and malignant lesions, favored by the lifelong immunosuppression. Vascularized composite tissue allografts (VCA) have been introduced recently, and relevant data are sparse. Two patients with skin cancers (one with basal cell carcinoma and one with squamous cell carcinomas) have been so far reported in this patient group. Since 2000 we have been following 9 recipients of VCA (3 face, 6 bilateral hands) for the development of rejection and complications of the immunosuppressive treatment. Among the 9 patients, one face-grafted recipient was diagnosed with nodular-pigmented basal cell carcinoma of her own facial skin 6 years after graft, and one patient with double hand allografts developed disseminated superficial actinic porokeratosis, a potentially premalignant dermatosis, on her skin of the arm and legs. Similar to RSOT, recipients of VCA are prone to develop cutaneous premalignant and malignant lesions. Prevention should be applied through sun-protective measures, regular skin examination, and early treatment of premalignant lesions

Control of prostate cancer by transrectal HIFU in 227 patients.

International audiencePURPOSE: To evaluate the results of high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer with reference to disease-related prognostic factors. MATERIALS AND METHODS: Patients with T1-2 localized prostate cancers, prostate specific antigen (PSA