Flashcards on Facial Transplantation: Comprehensive Medical Overview
Facial Transplantation: Comprehensive Medical Overview
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Composite tissue allotransplantation
36 cards
Card 1
Question: What is the standard induction treatment approach for composite tissue allotransplantation (CTA)?
Answer: Injection of monoclonal or polyclonal antilymphocyte antibody begun in the operating room just after completion of anastomosis.
Card 2
Question: What maintenance immunosuppressive tri-therapy is commonly used after induction in CTA?
Answer: Mycophenolate mofetil (MMF), tacrolimus (FK506/Prograf), and corticosteroids.
Card 3
Question: How is antilymphocyte serum therapy monitored in CTA patients?
Answer: By daily measurement of CD3+ T‑lymphocyte cell count.
Card 4
Question: What target blood level is recommended for tacrolimus in the immediate post-transplant period?
Answer: 10–15 ng/mL (with an initial target of about 5 ng/mL on day 1 and 10–15 ng/mL during the first month).
Card 5
Question: What is the target mini‑AUC range used to monitor mycophenolate (CellCept) in CTA protocols?
Answer: A mini‑AUC target of 40–50 ng·mL (measured weekly from day 4).
Card 6
Question: Describe the typical prednisone/prednisolone dosing schedule used during the induction period in CTA protocols (first 30 days).
Answer: D0: 250 mg IV before thymoglobulin and in ICU; D1: 250 mg before thymoglobulin; D2: 125 mg before thymoglobulin; D3: switch to prednisone 60 mg; D4–D1
Card 7
Question: What thymoglobulin (TG) regimen is described for induction in CTA?
Answer: Thymoglobulin 1.25 mg/kg from day 0 to day 10, with a first perfusion over 10 hours and subsequent perfusions over >4 hours.
Card 8
Question: What antiviral prophylaxis is recommended for CMV mismatch in CTA patients?
Answer: Valganciclovir 900 mg/day for 6 months, with monitoring of CMV viremia.
Card 9
Question: What are two tolerance-induction strategies under investigation for CTA mentioned in the content?
Answer: Concomitant donor hematopoietic stem cell (bone marrow) transplantation and extracorporeal photochemotherapy (ECP) to induce peripheral tolerance.
Card 10
Question: Why is myeloablative donor bone marrow transplantation generally not applicable for CTA?
Answer: Because myeloablation removes the recipient's bone marrow, altering their immune system and risking graft-versus-host disease (GVHD); it is only used