Risk Acceptance and Expectations of Scalp Allotransplantation

• Published in: Archives of craniofacial surgery Vol. 17; no. 2; pp. 68 - 76
• Main Authors: Choi, Jun Ho, Kim, Kwang Seog, Shin, Jun Ho, Hwang, Jae Ha, Lee, Sam Yong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Cleft Palate-Craniofacial Association 01.06.2016; 대한두개안면성형외과학회
• Subjects: Original; 성형외과학; Reconstructive surgical procedures; Surveys and questionnaires; Scalp; Patient acceptance of health care; Vascularized composite allotransplantation
• ISSN: 2287-1152; 2287-5603
• DOI: 10.7181/acfs.2016.17.2.68

In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.