Facial Transplantation in a Nationalized Health System: The Canadian Experience

Background:. Facial transplantation (FT) is recognized as the ultimate reconstruction for severely disfigured patients. The substantial cost of these procedures in a nationalized health system has not been extensively published. The first Canadian FT performed in May 2018 was a great opportunity to...

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Main Authors: Etienne Lorquet, MD, Alexander Govshievich, MD, André Chollet, MD, FRCSC, Dominique M. Tremblay, MD, FRCSC, Daniel E. Borsuk, OQ, MD, MBA, FRCSC, FACS
Format: Article
Language:English
Published: Wolters Kluwer 2021-01-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003357
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author Etienne Lorquet, MD
Alexander Govshievich, MD
André Chollet, MD, FRCSC
Dominique M. Tremblay, MD, FRCSC
Daniel E. Borsuk, OQ, MD, MBA, FRCSC, FACS
author_facet Etienne Lorquet, MD
Alexander Govshievich, MD
André Chollet, MD, FRCSC
Dominique M. Tremblay, MD, FRCSC
Daniel E. Borsuk, OQ, MD, MBA, FRCSC, FACS
author_sort Etienne Lorquet, MD
collection DOAJ
description Background:. Facial transplantation (FT) is recognized as the ultimate reconstruction for severely disfigured patients. The substantial cost of these procedures in a nationalized health system has not been extensively published. The first Canadian FT performed in May 2018 was a great opportunity to address this subject and evaluate the viability of such a program. Methods:. A detailed patient chart review was performed and a cost per unit approach was used to estimate the procedure cost. The preoperative, operative, and the postoperative periods up to 1-year after the surgery were analyzed. Financial support from private sponsors and Hospital Fund donations were considered. The literature on international FT and national solid organ transplantation was reviewed. Results:. The overall 1-year cost was estimated at $440,224 (2018 CAD). The costs are explained by a long hospital length of stay, costly immunosuppressive therapy, and high immunosuppression-related complications. Those findings are consistent with international FT literature. The societal impact of the surgery was minimized with a $36,921 (2018 CAD) grant obtained from an external contributor. Interestingly, the hospital foundation sustained a 794% increase in donations ($1,787,148; 2019 CAD) the year following the surgery. Conclusion:. Our experience confirmed that the combination of private funding, with positive goodwill and hospital donations, is a workable model for innovative surgery in the setting of a nationalized health system with financial restrictions.
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spelling doaj.art-1a9208f4223243eeb77354c1e4eb69432022-12-21T20:17:05ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742021-01-0191e335710.1097/GOX.0000000000003357202101000-00032Facial Transplantation in a Nationalized Health System: The Canadian ExperienceEtienne Lorquet, MD0Alexander Govshievich, MD1André Chollet, MD, FRCSC2Dominique M. Tremblay, MD, FRCSC3Daniel E. Borsuk, OQ, MD, MBA, FRCSC, FACS4From the Maisonneuve Rosemont Hospital, Montreal, Quebec, Canada.From the Maisonneuve Rosemont Hospital, Montreal, Quebec, Canada.From the Maisonneuve Rosemont Hospital, Montreal, Quebec, Canada.From the Maisonneuve Rosemont Hospital, Montreal, Quebec, Canada.From the Maisonneuve Rosemont Hospital, Montreal, Quebec, Canada.Background:. Facial transplantation (FT) is recognized as the ultimate reconstruction for severely disfigured patients. The substantial cost of these procedures in a nationalized health system has not been extensively published. The first Canadian FT performed in May 2018 was a great opportunity to address this subject and evaluate the viability of such a program. Methods:. A detailed patient chart review was performed and a cost per unit approach was used to estimate the procedure cost. The preoperative, operative, and the postoperative periods up to 1-year after the surgery were analyzed. Financial support from private sponsors and Hospital Fund donations were considered. The literature on international FT and national solid organ transplantation was reviewed. Results:. The overall 1-year cost was estimated at $440,224 (2018 CAD). The costs are explained by a long hospital length of stay, costly immunosuppressive therapy, and high immunosuppression-related complications. Those findings are consistent with international FT literature. The societal impact of the surgery was minimized with a $36,921 (2018 CAD) grant obtained from an external contributor. Interestingly, the hospital foundation sustained a 794% increase in donations ($1,787,148; 2019 CAD) the year following the surgery. Conclusion:. Our experience confirmed that the combination of private funding, with positive goodwill and hospital donations, is a workable model for innovative surgery in the setting of a nationalized health system with financial restrictions.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003357
spellingShingle Etienne Lorquet, MD
Alexander Govshievich, MD
André Chollet, MD, FRCSC
Dominique M. Tremblay, MD, FRCSC
Daniel E. Borsuk, OQ, MD, MBA, FRCSC, FACS
Facial Transplantation in a Nationalized Health System: The Canadian Experience
Plastic and Reconstructive Surgery, Global Open
title Facial Transplantation in a Nationalized Health System: The Canadian Experience
title_full Facial Transplantation in a Nationalized Health System: The Canadian Experience
title_fullStr Facial Transplantation in a Nationalized Health System: The Canadian Experience
title_full_unstemmed Facial Transplantation in a Nationalized Health System: The Canadian Experience
title_short Facial Transplantation in a Nationalized Health System: The Canadian Experience
title_sort facial transplantation in a nationalized health system the canadian experience
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003357
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AT dominiquemtremblaymdfrcsc facialtransplantationinanationalizedhealthsystemthecanadianexperience
AT danieleborsukoqmdmbafrcscfacs facialtransplantationinanationalizedhealthsystemthecanadianexperience