Facial vascularized composite allotransplantation: Mapping global research trends and scientific impact.

BACKGROUND

Facial vascularized composite allotransplantation (VCA) has emerged as a transformative reconstructive option for patients with severe facial disfigurement. Since its clinical introduction, research has expanded substantially, encompassing surgical innovation, immunology, ethical considerations, and long-term outcomes. This study aimed to analyze the global scientific landscape of facial VCA and identify key contributors, landmark publications, and emerging research trends through a bibliometric approach.

METHODS

A bibliometric analysis of the PubMed database was conducted in March 2026, including publications from 1979 to 2026. A total of 457 articles met the inclusion criteria. Bibliometric indicators such as annual scientific output, authorship patterns, institutional productivity, country contributions, collaboration networks, and keyword trends were analyzed using VOSviewer and the Bibliometrix R package.

RESULTS

Scientific production increased markedly after 2009, peaking around 2019 with sustained activity thereafter. The most productive authors were Dr Pomahac B. (n = 81), Dr Rodriguez E.D. (n = 48), and Dr Siemionow M. (n = 28). Harvard Medical School was the leading institution, and the United States dominated global output. Plastic and Reconstructive Surgery was the most productive journal. The most cited publication was "Facial transplantation: the first 9 years" (308 citations). Keyword analysis revealed a shift toward emerging topics including antibody-mediated rejection, chronic rejection, biomarkers, proteomics, C4d, and donor-specific antibodies.

CONCLUSIONS

Facial VCA research has expanded rapidly, driven by high-volume centers and influential studies. Emerging trends emphasize advanced immunologic monitoring and molecular approaches, which may improve long-term graft survival and clinical outcomes.