International Society of Vascularized Composite Allotransplantation Update

Under the auspices of the ISVCA and with the support of TTS, the Second International Chauvet Workshop was held in Paris from September 17-20, 2016. Attendees came from countries around the world including centers from Europe (Austria, France, Italy, Poland, Sweden), USA, Mexico, Turkey, India, Australia, and representing the majority of teams involved in upper extremity (14 teams), face (6 teams) and uterus (2 teams) transplantations.
The second workshop built upon the success of the first Chauvet Workshop by creating a platform for the open and collegial discussion regarding psychosocial and ethical issues in VCA, including upper extremity, face and uterus transplantations.

During the first Chauvet workshop, the attendees highlighted the domains of importance in the psychosocial assessment and management of upper extremity transplanted patients and the need for an international consensus on them. One of the goals of the second workshop was to create a set of “recommendations” on the basis of a survey sent to all active centers. The results of the survey were presented and discussed during the workshop.

An update on the psychosocial issues in face transplantation was followed by an in-depth discussion organized around four roundtables on critical topics in face transplantation including: suicide and face transplantation, body image, psychological follow-up and support of the face grafted patients and ethical issues. These discussions aimed at defining the patient selection process and candidate eligibility, establishing the risk/benefit balance, determining the patients’ ability to understand risk and describing the optimal follow-up of face grafted patients.

Uterus transplantation is an emerging area within VCA with unique psychosocial and ethical issues, which were presented by the teams currently involved in this type of transplantation. This presentation was enhanced by the participation of transplant ethicists who considered the possible benefits and risks for this patient population.