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Outcomes of microvascular flap reconstruction of the head and neck in patients receiving systemic immunosuppressive therapy for organ transplantation
Author(s) -
Schaverien Mark V.,
Dean Riley A.,
Myers Jeffrey N.,
Fang Lin,
Largo Rene D.,
Yu Peirong
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25035
Subject(s) - medicine , surgery , organ transplantation , head and neck cancer , free flap , transplantation , population , head and neck , radiation therapy , environmental health
Background For organ transplant recipients, cancer secondary to immunosuppressive therapy threatens long‐term survival. The associated multiple comorbidities make major free flap reconstruction following cancer surgery a complicated event. This study evaluates the outcomes of free flap reconstruction in this population. Methods A retrospective chart review of all head and neck free flap cases in patients with a history of organ transplantation receiving systemic immunosuppressive therapy between 2005 and 2017 at a single‐institution was conducted. Results Of 57 organ transplant patients, 25 patients (28 flaps) were included. Flaps used included the anterolateral thigh ( n = 17), radial forearm ( n = 4), latissimus dorsi ( n = 3), fibula ( n = 2), lateral arm ( n = 1), and thoracodorsal artery perforator ( n = 1) flaps. The most common organ transplant was kidney, then lung, liver, and heart. Mean inpatient stay was 8.2 days (range, 4‐28). Complications occurred in 15 patients, with no total or partial flap losses. Conclusion Major head and neck free flap reconstructive surgery can be performed safely in organ transplant patients receiving immunosuppressive therapy. Meticulous multidisciplinary care is required to achieve consistently successful outcomes.