Composite Tissue Allotransplantation of the Hand and Face

This policy addresses composite tissue allotransplantation of the hand and face as a surgical option to restore appearance and/or specific functional abilities (e.g., grasping, blinking, mouth closure, oral intake) in patients with severe facial disfigurement from trauma, burns, disease or congenital defects and in individuals with hand/upper‑extremity loss who cannot be adequately helped by prosthetics or conventional reconstruction. The procedure is considered experimental/investigational and not covered by the payer; it requires immediate and lifelong follow‑up, lifelong immunosuppression and intensive rehabilitation, and carries substantial risks including high rates of acute rejection, opportunistic infections, metabolic complications and possible graft loss, with coverage ultimately subject to the member’s contract and state rules.

"Facial transplantation to restore appearance and psychosocial function when traditional reconstructive options are inadequate."