Chapter 8-Standardizing Postoperative Outcome Assessment After Face Transplantation: A Proposed Core Assessment Framework.

Outcome assessment after face transplantation remains heterogeneous, limiting comparison of recovery, patient benefit, and treatment burden across programs. We sought to define a face-specific core outcome set for longitudinal postoperative assessment, informed by the NYU Langone experience and its published outcome literature. We performed a methodological inventory of postoperative assessments used across 4 NYU Langone face transplant recipients treated between 2015 and 2023 and reviewed face-relevant peer-reviewed publications available through September 2026. Recipient-level outcome values were not reanalyzed. Measures were prioritized for clinical relevance, repeatability, and suitability for longitudinal comparison. Twenty-three relevant publications from the NYU program informed the framework. The proposed core outcome set comprises 6 domains: (1) allograft integrity and surgical outcomes; (2) rejection, immunologic surveillance, and immunosuppression-related morbidity; (3) facial sensory and motor recovery; (4) speech, swallowing, and oral function; (5) structural and region-specific facial outcomes; and (6) patient-reported outcomes, rehabilitation, and treatment burden. This face-specific framework provides a clinically focused minimum data set for longitudinal outcome assessment after face transplantation. Consistent use may improve patient tracking and facilitate more meaningful comparison across programs, while prospective multicenter implementation will be necessary to refine and validate the proposed core set.