Abstract
Composite tissue allotransplantation (CTA) has emerged as a promising surgical option
to restore the form and function of missing or severely damaged structures such as
the face, hands, or trachea. Currently, there are four active CTA programs in the
United States and numerous others under development. The process of development of
a CTA program in the United States involves successful collaboration between a strong
project leader with vested clinical research interest, a multidisciplinary team of
investigators, an Institutional Review Board, a regional Organ Processing Organization
(PO), and the hospital's administration. The process of establishment of a CTA program
can be slow and lengthy, therefore the project leader must strive to maintain the
enthusiasm alive and drive the project forward. At all phases of development, the
project must remain focused on the patients, must recognize and address all potential
patient safety issues, must take into account the concerns, issues and logistic hurdles
faced by the OPO, and must be financially responsible by ensuring that postoperative
costs related to medical care and life-long immunosuppression are covered by medical
insurance. This article describes the process of establishment of a CTA program at
Brigham and Women's Hospital, Boston, MA with special emphasis on strategy and planning.
Keywords
composite tissue allotransplantation - composite tissue allotransplantation program
- face transplantation - hand transplantation
