Facial Transplantation in a Blind Patient: Psychologic, Marital, and Family Outcomes at 15 Months Follow-Up

Background: Quality of life has frequently been reported to improve after vascularized composite allo-transplantation of the face. However, psychosocial functioning of the partner or of particular patient groups such as blind patients are until now less well investigated. Objective: The aim of this study is to investigate psychologic, marital, and,family functioning of a blind 54-year-old patient, Mr. A, and his partner after facial transplantation. Methods: Depressive and anxiety,symptoms, hopelessness, personality, coping, resilience, illness cognitions, marital support, dyadic adjustment, family functioning, and quality of life of Mr. A and his partner were assessed before and after facial transplantation and at 15 months follow-up. Reliable change index (RCI) was further calculated to evaluate the magnitude of change. Results: Most psychologic, marital, and family scores of both Mr. A and his partner were within a normative and healthy range before and after transplant and at 15 months,follow-up. Resilience (3.6), affective responsiveness (RCI: -3.6), and disease benefits (RCI: 2.6) of Mr. A farther improved at 15 months follow-up whereas the physical quality of life (RCI: -14.8) strongly decreased. Only marital support (RCI: -2.1) and depth (RCI: -2.0) of the partner decreased at 15 months. Conclusions: The results of this study point to positive psychosocial outcomes in a blind patient after,facial transplantation. Further, they may underscore the importance of good psychosocial functioning before transplantation of both partners and of their involvement in psychologic and psychiatric treatment. Clinical Question/Level of Evidence: Therapeutic, V.