Experimental Studies in Face Transplantation: Primate Model

In offering optimal reconstruction for severe facial disfigurement, the advent of human face transplantation constitutes a landmark achievement in medicine and stands as a historical testament to the creativity, intelligence, ingenuity, and boldness of the human species. Facial allotransplantation has been modeled in rodents, canines, swine, and lagomorphs. However, human and rodent immune systems are dissimilar to a degree that precludes translation of tolerance induction protocols to humans. Nonhuman primates have long been used as translational models of human immunology and transplant immunobiology due to recent evolutionary divergence and shared major histocompatibility complex (MHC) II polymorphisms. We have developed a reproducible heterotopic model of nonhuman primate facial CTA permissive of long-term rejection-free survival. The purpose of this chapter is to share our experience in the development and maturation of this model, from surgical technique and immunosuppressive strategies, to experimental results and future directions.