The first face transplant operation in the United States has been completed and initial results are positive, reports the medical team at the Cleveland Clinic. The patient, who had suffered severe facial disfigurement from trauma, had 80 percent of her face replaced with one taken from a cadaver, leaving only her own upper eyelids, forehead, lower lip, and chin. After the transplant, “I must tell you how happy she was when with both her hands she could go over her face and feel that she has a nose, feel that she has a jaw,” said the lead surgeon, Dr. Maria Siemionow [AP].
Although the woman’s identity and the nature of her trauma has not been revealed, doctors say her injuries were so severe that she lacked a nose and palate, and could not eat or breathe on her own without a special opening into her windpipe [AP]. The 22-hour-long surgery took place sometime in the last two weeks and is the most radical facial transplant ever attempted. Along with about 500 square centimeters of skin, the transplant also included bones, muscles, blood vessels, nerves, a nose, sinuses, the upper jaw, and even some teeth. The doctors hoped the operation would allow her to regain her sense of smell and ability to smile [AFP].
Although the woman passed the first hurdle — there was no rejection of the new face at the time of surgery — she can experience a rejection reaction at any time [for] the rest of her life [The New York Times]. Doctors will have to prescribe powerful immunosuppressive drugs to prevent rejection but carefully monitor the effects to allow her body to fight off infections. If the drugs fail and rejection does occur, doctors may have little recourse besides attempting to replace the transplant with skin grafts from the patient’s own body.
Siemionow, a well-known hand surgeon, received the hospital’s approval for such a radical and experimental face transplant back in 2004, but had not found an appropriate candidate for the surgery until now. Besides matching the patient with a compatible donor, the patient needed to be severely disfigured yet psychologically stable and able to commit to a lifetime of immunosuppressant drugs. Siemionow said, “This patient exhausted all conventional means of reconstruction, and is the right patient” [AP].
Three partial face transplants have been done in the past, two in France and one in China. Some experts have questioned the ethics behind risky face transplants, arguing that they are not life-saving but only life-enhancing, and not worth the potential “living hell” that would be transplant failure. But Siemionow says in many cases severe facial disfigurement effectively banishes a person from society and leads to high suicide rates. “Our patient was called names and was humiliated,” she said. “You need a face to face the world” [AP].
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Image: Cleveland Clinic
December 18th, 2008 at 10:12 am
We, love this Doctor for her insight, skills and heart!!!