UCLA launches program to provide face, hand and abdominal wall transplants

In a major step into a new transplantation frontier, UCLA has established a first-of-its-kind program to restore functionality and enhance quality of life for people who have suffered severe trauma or other disfiguring injuries to the upper extremities, face or abdomen.

The UCLA Section of Reconstructive Transplantation represents a multidisciplinary effort to use a new transplantation approach known as vascularized composite allotransplantation to treat patients whose tissue loss cannot be remedied through conventional techniques.

While lifesaving solid-organ transplants have become increasingly common at major centers such as UCLA, reconstructive transplantation — a complex surgery involving composite tissues (bones, tendons, arteries, nerves) — marks a new direction for the field. Unlike organ transplants, which are performed to save lives, reconstructive transplants aim to dramatically improve them.

"Reconstructive transplantation is where we were with solid-organ transplantation in the mid-1980s," said Dr. Ronald W. Busuttil, professor and executive chair of the department of surgery at the David Geffen School of Medicine at UCLA, who established UCLA's liver transplant program in 1984, the first on the West Coast. "With the experience that has been accrued in several centers throughout the world with reconstructive transplantation, it is clear that for certain patients, the outcomes can be life-changing and that major transplant centers such as UCLA should be pursuing this approach."

In making the announcement, Busuttil appointed Dr. Kodi Azari chief of the reconstructive transplantation section, which is part of the UCLA Division of Liver and Pancreas Transplantation. Azari is a pioneer in the field, having led the UCLA surgical team that performed the West Coast's first reconstructive hand transplant in March and having served as one of the lead surgeons on four previous hand transplants in his collaborations with the University of Pittsburgh.

"UCLA has been a leader in transplantation for the past quarter-century, and this is a natural extension of that leadership," Azari said. "We are excited to be able to offer a program of reconstructive transplantation for patients, as well as research to further advance the field."

One of the key tenets of plastic surgery is to use similar tissues from other parts of the patient's body in reconstruction. But for parts of the body such as hands and the nose and mouth area of the face, Azari said, there is no similar tissue — in many cases making conventional reconstruction impossible. Through advanced microsurgical techniques, Azari and his colleagues use composite tissues to construct what the body doesn't readily provide.

The UCLA Section of Reconstructive Transplantation will take advantage of the vast transplantation infrastructure in place at UCLA, which boasts the world's largest solid-organ transplant program. The reconstructive transplants will focus on three parts of the body: