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Determining the cost a of face transplant: A systematic review
Michael Wells, Rebecca Knackstedt, Baraa Nawash, Brian Gastman
Cleveland Clinic Foundation
2020-01-29
Presenter: Michael Wells
Affidavit:
This study represent the original work of the resident, and I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Steven Bernard
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction:
Face transplantation is a powerful reconstructive tool to restore form and function. However, it is associated with significant costs related to surgery, immunosuppressive medications, complications and multi-disciplinary evaluation and follow-up. Thus, critical analysis of the initial and long-term projected costs associated with face transplantation are required to determine the role of this surgical option for complex facial defects
Methods:
A review of available literature was performed on PubMed using relevant search terms. Articles that did not include a full or partial face transplant, were in a foreign language, analyzed non-human or cadaveric studies, or lacked the full text were excluded.
Results:
271 abstracts were screened and 41 papers analyzing 44 patients fit inclusion criteria. Ten papers reported on surgical time, but only two commented on costs. Immunosuppressive regimen was described in 27 papers, but only one paper reported the cost. Length of intensive care unit stay was described in two papers, with a single paper reporting cost. Rehabilitation was described in seven papers, but none commented on cost. Complications were described in 22 papers, but only one described the cost of CMV-related hospitalizations.
Conclusion:
The majority of the articles analyzed features of direct patient care, but did not describe the associated costs. The maximum followup of ten years also makes it difficult to predict future costs, such as chronic rejection and second transplants. Further investigation of the financial aspects of face transplants, as well as multidisciplinary studies and collaboration, are vital to determine the efficacy of face transplants.
