First Face Transplant

[Guest guest]

I really hope it works and is not rejected. I don't like the idea

that the face has to be cut off the donor before they switch off the

ventilator machine.

 

Jo

 

Surgeons in France have carried out the first face transplant, it has

been reported.

The woman had lost her nose, lips and chin after being savaged by a

dog.

 

In the controversial operation, tissues, muscles, arteries and veins

were taken from a brain-dead donor and attached to the patient's

lower face.

 

Doctors stress the woman will not look like her donor, but nor will

she look like she did before the attack - instead she will have

a " hybrid " face.

It has been technically possible to carry out such a transplant for

some years, with teams in the US, the UK and France researching the

procedure.

 

Skin from another person's face is better for transplants as it will

be a better match than skin from another part of the patient's body,

which could have a different texture or colour.

 

But the ethical concerns of a face transplant, and the psychological

impact to the patient of looking different has held teams back.

 

Concerns relating to immunosuppression, psychological impact and the

consequence of technical failure have so far prevented ethical

approval of the procedure in the UK, though doctors here are fully

able to perform transplants.

 

The 38-year-old French patient from the northern French town of

Valenciennes underwent extensive counselling before her operation,

which is believed to have lasted at least five hours, and which took

place at the weekend at a hospital in Amiens.

 

The French magazine Le Point reports that the tissues, muscles,

arteries and veins needed for the transplant were taken from a multi-

organ donor in the northern city of Lille, who was brain-dead.

 

The operations were carried out by a team led by Professor Bernard

Devauchelle and Professor Jean Michel Dubernard.

 

In a statement, the hospital said the woman had been gravely

disfigured in the attack in May this year.

 

She has been unable to speak or eat properly since.

 

It added that the woman - who wishes to remain anonymous - was

in " excellent general health " and said the graft looked normal

 

It is not clear whether an individual could be left worse off in

the event that a face transplant failed

 

Like any other transplant patient, the woman will have to take

immunosuppressant drugs to help her body cope with the donated

tissue.

 

Doctors working in the field say many could benefit from the

procedure, including 10,000 burns victims in the UK.

 

Iain Hutchison, an oral-facial surgeon at Barts and the London

Hospital, said: " This is the first face transplant using skin from

another person. "

 

But there are medical, and ethical, concerns of facial transplants.

 

Mr Hutchison, who is chief executive of Saving Faces - the Facial

Surgery Research Foundation, warned blood vessels in the donated

tissue could clot, the immunosuppressants could fail - and would

increase the patient's risk of cancer. "

 

Mr Hutchison added there were ethical and moral issues around

donating facial tissue.

 

" Where donors would come from is one issue that would have to be

considered.

 

" The transplant would have to come from a beating heart donor. So,

say your sister was in intensive care, you would have to agree to

allow their face to be removed before the ventilator was switched

off.

 

" And there is the possibility that the donor would then carry on

breathing. "

 

Stephen Wigmore, chair of British Transplantation Society's ethics

committee, said: " The extent of facial expression which will occur in

the long term is unknown.

 

" The skin tends to promote rejection by the immune system very

strongly and immunosuppression is likely to need to be kept at high

levels for prolonged periods of time.

 

" It is not clear whether an individual could be left worse off in the

event that a face transplant failed. "

 

Mr Michael Earley, a member of the Royal College of Surgeon's facial

transplantation working party, said: " If successful, this is a major

breakthrough in facial reconstruction.

 

" It appears that this has been a partial face transplant

incorporating the nose and lips; therefore issues relating to

similarity in appearance between donor and recipient are unlikely to

be a major problem.

 

" We wish the patient and the team a successful outcome and look

forward to learning more about the details of the procedure which

could be a major step forward for the facially disfigured. "