Skin Elasticity: A Potential Surrogate Marker for Facial Allograft Skin Fibrosis—A Case Series

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-06-03 DOI:10.1111/ctr.70175

Viola A. Stögner, Sam Boroumand, Aliyar Zahedi Vafa, Lioba Huelsboemer, Martin Kauke-Navarro, Richard Formica, David Leffell, Siba Haykal, Bohdan Pomahac

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引用次数: 0

Abstract

Introduction

Rejection represents a major and common complication in vascularized composite allotransplantation (VCA). Over time, recurrent acute or chronic rejection can lead to vascular and dermal fibrosis and potentially graft loss. To date, a non-invasive monitoring tool to capture chronic graft changes among VCA recipients has not been established. This pilot study aims to assess the potential value of noninvasive skin elasticity measurements for surveillance of longitudinal fibrosis of facial allografts.

Methods

Viscoelasticity was non-invasively assessed via triplicate measurements of the transplanted facial skin on bilateral cheeks and native skin on bilateral upper arms in six face transplant recipients using the well-established Cutometer Dual MPA 580. Data were statistically compared with recipient/donor age, post-transplant years (PTYs), and cumulative rejection burden (CRB), smoking status, ethnicities, and immunosuppressive regimens.

Results

A significant (p < 0.05) negative linear relationship between CRB and the Cutometer parameters R2 (gross elasticity), R5 (net elasticity), and R7 (elasticity recovery) was found, which was not observed in control measurements of native skin of VCA recipients. Results were ranked into a three-level severity scale. Comparison with PTYs further revealed a significant negative linear relationship with R2 and R5 values. No statistically significant correlation was detected across R values when evaluated against recipient/donor age, smoking status, ethnicity, or immunosuppressive regimens.

Conclusions

Although diagnosis and monitoring of rejection-associated degenerative skin changes currently still rely on biopsies, this exploratory study identifies skin elasticity as a promising surrogate marker for facial allograft fibrosis.

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皮肤弹性：面部同种异体皮肤纤维化的潜在替代指标——一个病例系列

排斥反应是血管化复合异体移植（VCA）中一个主要和常见的并发症。随着时间的推移，复发性急性或慢性排斥反应可导致血管和真皮纤维化，并可能导致移植物丢失。迄今为止，尚未建立一种非侵入性监测工具来捕捉VCA受者的慢性移植物变化。这项初步研究旨在评估无创皮肤弹性测量对监测面部同种异体移植物纵向纤维化的潜在价值。方法对6例面部移植受者的双侧面颊和双侧上臂皮肤进行了无创的粘弹性测量。将数据与受体/供体年龄、移植后年数（pty）、累积排斥负担（CRB）、吸烟状况、种族和免疫抑制方案进行统计比较。结果：p <；CRB与Cutometer参数R2（总弹性）、R5（净弹性）和R7（弹性恢复）呈负线性关系，而在VCA受体皮肤的对照测量中没有观察到这种关系。结果被分为三级严重程度量表。与PTYs的比较进一步显示与R2和R5值呈显著的负线性关系。当评估受体/供体年龄、吸烟状况、种族或免疫抑制方案时，R值之间没有发现统计学上显著的相关性。结论：尽管排斥相关的退行性皮肤变化的诊断和监测目前仍依赖于活检，但这项探索性研究发现，皮肤弹性是一种有希望的面部同种异体移植纤维化替代标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.