Impact of Solid Organ Transplant History on Outcomes in Head and Neck Microvascular Reconstruction

Authors

• Domenica Voli, Thomas Jefferson UniversityFollow
• Sarah R. Harrington, Thomas Jefferson UniversityFollow
• Daniel Uralov, Thomas Jefferson UniversityFollow
• Janvi J. Shukla, Thomas Jefferson UniversityFollow
• Hani Samarah, Thomas Jefferson UniversityFollow
• Marina Aweeda, Thomas Jefferson UniversityFollow
• Krishna Koka, Thomas Jefferson UniversityFollow
• Shaunak Ganju, Thomas Jefferson UniversityFollow
• Kelly Bridgham, Thomas Jefferson UniversityFollow
• Eric V. Mastrolonardo, Thomas Jefferson UniversityFollow
• Arielle G. Thal, Thomas Jefferson UniversityFollow
• Richard A. Goldman, Thomas Jefferson UniversityFollow
• Adam J. Luginbuhl, Thomas Jefferson UniversityFollow
• Larissa Sweeny
• Mark K. Wax
• Joseph M. Curry, Thomas Jefferson UniversityFollow

Document Type

Abstract

Publication Date

2-11-2026

Academic Year

2025-2026

Comments

Presented at the 2026 Scholarly Inquiry (SI) Research Project Symposium.

Abstract

Introduction/Purpose: Free tissue transfer (FTT) is a commonly used technique in head and neck reconstructions. Many factors influence FTT success, including immunosuppression. Patients with solid organ transplants represent a unique population, as the lifelong immunosuppression predisposes them to head and neck cancers and poor wound healing. This study assesses postoperative outcomes and long-term survival in patients with head and neck cancer requiring FTT with a history of solid organ transplant (SOT), compared to matched non-transplant controls.

Methods: Patients with head and neck cancer who underwent FTT were identified in multi-institutional databases and the national TriNetX database. Patients with a history of SOT were matched 1:1 with non-transplant control patients based on comorbidities and demographics. Thirty-day outcomes and thirty-day complications were collected, as well as data on overall survival (OS) and disease-free survival (DFS) at 1, 3, and 5 years. Kaplan-Meier analyses were performed.

Results/Conclusions: Within the multi-institutional databases, the 30-day mortality was 11.1% for SOT patients and 2.8% for non-transplant controls. Rates of 30-day flap failure, medical and surgical complications, and readmissions were similar between groups. Five-year OS was significantly lower for SOT patients, while one- and three- year OS between the two groups did not show any significant difference. Five-year DFS did not differ significantly. Among the TriNetX cohort, 30-day mortality and complication rates were comparable, while 3- and 5-year OS were significantly lower among SOT patients. Overall, the results indicate that FTT is feasible in SOT patients; however, long-term survival is reduced, which suggests the need for multidisciplinary care.

Recommended Citation

Voli, Domenica; Harrington, Sarah R.; Uralov, Daniel; Shukla, Janvi J.; Samarah, Hani; Aweeda, Marina; Koka, Krishna; Ganju, Shaunak; Bridgham, Kelly; Mastrolonardo, Eric V.; Thal, Arielle G.; Goldman, Richard A.; Luginbuhl, Adam J.; Sweeny, Larissa; Wax, Mark K.; and Curry, Joseph M., "Impact of Solid Organ Transplant History on Outcomes in Head and Neck Microvascular Reconstruction" (2026). Phase 1. Paper 19.
https://jdc.jefferson.edu/si_ctr_2028_phase1/19

Language

English