How to ask for a vascularised composite allograft and tissues
Résumé
In France the years 2000 marked a series of world firsts: composite tissue transplantations, arm graft followed by partial then total facial graft. These new transplantations were legitimate according to the ethical committee, but was the request for composite tissue conceivable for the relatives? For the procurement coordinator this special request constituted a real challenge. The central question was: how can such a question be expressed as it will inevitably impair the integrity of the donor? Do we have to envisage a destitute donor? It seemed to be tempting, but from experience it provides false security. This specific request can be made to families in which the deceased person was in favor of organ donation. The main difficulty engendered by this new kind of retrieval is the physical injury, especially for the face. For the coordinator, this situation is not easy to handle because s/he always has to make sure that the relatives are not traumatized by the procurement. So it is very important to explain the process of restoration and its limits. The experience shows that the families can listen to this request and can answer it favorably, even if they are always shocked.