Analysis of Tissue-Specific Mechanisms of Acute Rejection in Face Transplants

• Applicant: Dr. Felix Klimitz
• Subject Area: Clinical Immunology and Allergology ; Pathology
• Term: since 2025
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 565697661

This project investigates the mechanisms of acute rejection in face transplantation or facial vascularized composite allotransplantation (fVCA), a groundbreaking surgical procedure that restores function and aesthetics in patients with severe facial deformities. Facial transplants involve multiple tissue types, such as skin and mucosa, which present unique immunological challenges. Current diagnostic tools primarily focus on skin biopsies to monitor rejection, but emerging evidence suggests that mucosa may play a more significant role in early rejection episodes. This project aims to redefine rejection diagnostics by integrating mucosal analysis into standard rejection grading systems. Using spatial single-cell sequencing (CosMx), the study will explore the cellular and molecular mechanisms of rejection in both skin and mucosa. By analyzing tissue samples from a biobank of face transplant recipients and including samples from future face transplant recipients, the research will identify immune cell populations and molecular pathways specific to each tissue type. This innovative approach will provide a detailed understanding of how rejection progresses in face transplants, revealing potential targets for personalized immunosuppressive therapies. The ultimate goal is to develop a novel, tissue-specific grading system for acute rejection in face transplants. This system will enhance the early detection and management of rejection, improving long-term outcomes while minimizing the side effects of immunosuppression. By addressing critical gaps in current practices, this research has the potential to transform clinical monitoring and treatment strategies, making facial transplantation a safer and more accessible option for patients worldwide.

• DFG Programme: WBP Fellowship
• International Connection: USA
• Host: Professor Dr. Bohdan Pomahac