Reconstructive microsurgery

Soft tissue transplants are a relatively recent development – only becoming possible after basic organ transplantation started happening in the late 60s and 70s. These days, reconstructive microsurgery is used to transplant tissues as well as organs - with bone, muscle, skin, and a blood supply. The magnification of a microscope is needed to complete the complex task (hence ‘microsurgery’).

Up until recently this reconstructive surgery has focused on tissue transplants from the same body – also known as autologous transplants – but advances to microsurgery have meant that plastic surgeons are no longer so limited.

France 1998, the first ‘allofgraft’ hand transplant

A pivotal moment happened in 1998, when a team of surgeons in Lyon, France, successfully performed a hand transplant to a patient’s body from another body. The operation was a technical success and demonstrated that skin, muscle and bone could be successfully transplanted from one body to another with support from modern immunosuppressive drugs. 

This encouraged other medical teams around the world to follow suit.

Since then, advances in reconstructive surgery have made it possible to reliably transplant a wide range of tissues and body parts from one body to another – a procedure also known as an ‘allograft’ – to correct hand, face and other soft tissue defects. 

The early results of these tissue transplants have been encouraging with successful prevention of graft rejection using current immunosuppressive drugs and therapy . A patient’s immune system has to be supressed using these therapies to stop it from damaging transplanted tissues – which can be perceived as ‘alien’ and attacked.

A hand transplant and its post-operative result are shown below (Images courtesy of Jewish Hospital and University of Louisville).

The possibility for full face transplants at the Royal Free London

Surgical developments have meant that there is now the possibility of performing full-face transplants to restore facial form and function - especially in patients where conventional reconstructive surgery would have relatively poorer outcomes, such as severe burns cases.

Find out more about our face transplant work and research in the left hand navigation.