Hair Transplantation in a Patient with a Renal Transplant

Abstract

Introduction: Necessary precautions should be taken to reduce the risk of infection and compromised wound healing that can be occur in patients, such as organ transplant recipients, who take immunosuppressives or corticosteroids. We report on Follicular Unit Transplantation (FUT) in a patient with a prior renal transplant.

Objective: This case study looks at preventive measures to minimize the risk of infection, poor wound healing, poor growth, and failure in hair transplant outcome for patients who have had an organ transplant.

Methods and Materials: A 26-year-old, Ludwig's grade II female came to our office with history of a renal transplant 11 years previously. Her medications were CellCept® 750mg/d, Sandimmune (cyclosporine) 125mg/d, prednisolone 5mg/d, aspirin 80mg/d, diltiazem 120mg/d, ranitidine 150mg/d and folic acid 1/d. The patient needed 2,000 grafts and the decision was made to perform a single FUT surgery. According to the consultation, aspirin and folic acid intake were discontinued two weeks and 10 days before surgery, respectively. Prednisolone intake was converted to stress dose 3 days before surgery and continued 3 days after surgery. It was then tapered to 10mg/d for 3 days and returned to normal daily dose on post-surgical day 7. In addition, oral cephalexin was started 2g/d 3 days prior to surgery. Other medicines were continued at the previous doses.

The patient was operated on under sterile conditions using tumescence on both the donor and recipient areas. Hyalase and trichophytic closure was used for strip harvesting. The Making Incisions First (MIF) method with custom blades was utilized to make recipient sites. Antibiotic intake was discontinued one week after surgery, at which time aspirin and folic acid were restarted.

Results: The patient was examined daily for two weeks after surgery. She had no signs of bleeding or infection. She was followed monthly up to one year. The outcome of hair transplantation and also wound healing was satisfactory.

Conclusion: We achieved very good results from hair transplantation in an immune deficient patient by choosing the proper technique and taking preventive measures against infection and poor wound healing. In addition, we consulted with the patient's appropriate medical specialists to change or stop some medication doses.