第8章——标准化面部移植术后结局评估：拟议的核心评估框架。
Chapter 8-Standardizing Postoperative Outcome Assessment After Face Transplantation: A Proposed Core Assessment Framework.
文献信息
| PMID | 42773955 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sergio A Segrera |
| 作者单位 | Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health. |
| 期刊 | The Journal of craniofacial surgery |
| SCI 分区 | Q3 |
| IF | 1.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 面部移植后的结局评估仍然异质，限制了各项目之间对恢复、患者获益和治疗负担的比较。我们试图定义一个针对面部的核心结局集，用于纵向术后评估，并以纽约大学朗格尼分校的经验及其已发表的结局文献为依据。方法：我们对2015年至2023年间接受治疗的4例纽约大学朗格尼分校面部移植受者的术后评估进行了方法学清点，并回顾了截至2026年9月可获得的与面部相关的同行评审出版物。未重新分析受者层面的结局值。根据临床相关性、可重复性和纵向比较的适用性对测量指标进行了优先排序。结果：来自纽约大学项目的23篇相关出版物为该框架提供了信息。拟议的核心结局集包括6个领域：（1）同种移植物完整性和手术结局；（2）排斥反应、免疫监测和免疫抑制相关发病率；（3）面部感觉和运动恢复；（4）言语、吞咽和口腔功能；（5）结构和区域特异性面部结局；（6）患者报告结局、康复和治疗负担。结论：这一针对面部的框架为面部移植后的纵向结局评估提供了一个以临床为重点的最小数据集。一致使用可能改善患者追踪，并促进各项目之间更有意义的比较，而前瞻性多中心实施将是完善和验证拟议核心集的必要条件。
英文摘要
Outcome assessment after face transplantation remains heterogeneous, limiting comparison of recovery, patient benefit, and treatment burden across programs. We sought to define a face-specific core outcome set for longitudinal postoperative assessment, informed by the NYU Langone experience and its published outcome literature. We performed a methodological inventory of postoperative assessments used across 4 NYU Langone face transplant recipients treated between 2015 and 2023 and reviewed face-relevant peer-reviewed publications available through September 2026. Recipient-level outcome values were not reanalyzed. Measures were prioritized for clinical relevance, repeatability, and suitability for longitudinal comparison. Twenty-three relevant publications from the NYU program informed the framework. The proposed core outcome set comprises 6 domains: (1) allograft integrity and surgical outcomes; (2) rejection, immunologic surveillance, and immunosuppression-related morbidity; (3) facial sensory and motor recovery; (4) speech, swallowing, and oral function; (5) structural and region-specific facial outcomes; and (6) patient-reported outcomes, rehabilitation, and treatment burden. This face-specific framework provides a clinically focused minimum data set for longitudinal outcome assessment after face transplantation. Consistent use may improve patient tracking and facilitate more meaningful comparison across programs, while prospective multicenter implementation will be necessary to refine and validate the proposed core set.