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US surgeons perform first near-complete facial transplant

Video by FRANCE 24

Latest update : 2009-05-10

Surgeons at the Cleveland Clinic in the United States have successfully carried out the first nearly complete face transplant in history. A French team at Lyon University was the first to perform a partial face transplant in 2005.

AFP - US surgeons have replaced 80 percent of a woman's face in what is considered the world's first nearly complete facial transplant, the Cleveland Clinic has announced.
  
It was the first such operation in the United States and the fourth known facial transplant to have been successfully performed to date. The procedure took place in recent weeks on a patient disfigured by a traumatic injury.
  
The hospital was due to hold a press conference Wednesday on the breakthrough surgery, after initially revealing the news on Tuesday without giving further details about the patient, who does not want to be identified.
  
Facial transplants are controversial because they carry heavy risks and are performed to improve a patient's quality of life rather than as a life-saving operation.
  
The risks include failure of the transplanted tissue and complications from anti-rejection drugs, which the patient must take for the rest of their life.
  
Bioethicist Dr. Arthur Caplan voiced stressed there were major ethical concerns involved with the procedure.
  
"It's one thing to go through life with a terribly distorted, mangled, injured face. It's another thing to have it slough off in a failed experiment," he told CNN television.
  
"No one hopes we'll have to deal with that ... possibility in this transplanted face," he said, suggesting that if the transplant failed, the patient would be in the direst straits.
  
"You would be there almost unable to breathe or eat and have to do it artificially," he said.
  
"I think you have to go in here saying to the person who tries this, 'if you get in that situation, we would be willing to either not give you treatment that would keep you going, or maybe give a lot of morphine to push you out of the picture to help you to die.' ... I know it's a radical thing to say. Imagine living with no face."
  
Carson Strong, a professor of human values and ethics at the University of Tennessee College of Medicine, echoed concern about the potential dangers of a rejection of the transplant.
  
"One case is merely an anecdote. It doesn't create a scientific basis to say it's safe for a patient to do this," Strong told The Washington Post.
  
If the graft fails "you could reasonably say the patient would be much worse off at that time than he or she had been before the transplant had been attempted," Strong added.
  
Doctors in France performed the first partial face transplant in 2005 on a 38-year-old woman, Isabelle Dinoire, who was disfigured in a dog attack.
  
In 2006, a Chinese man underwent a facial transplant including the connection of arteries and veins, and repair of the nose, lip and sinuses. A bear had mauled the 30-year-old farmer as he looked for stray sheep.
  
A 29-year-old man French man underwent surgery in 2007. He had a facial tumor called a neurofibroma caused by a genetic disorder.
  
The tumor was so massive that the man couldn't eat or speak properly.
  
The Cleveland Clinic became the first US hospital to approve the procedure four years ago.
  
Maria Siemionow, director of plastic surgery research at the clinic, performed the surgery along with a team of seven other doctors, according to clinic officials.
  
Siemionow has conducted extensive research transplanting the faces and limbs of laboratory rats.
  
A facial transplant involves the use of donor tissue to repair severe face disfigurement caused by burns, tumors, malformations or trauma, such as car crashes.
 

Date created : 2008-12-17

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