There is a special about this on the health channel right now. 10-11 est
From: "David K. Kelmer" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED], [email protected]
Subject: Re: [QUAD-L] Guardian Unlimited: Dog attack victim gets world's
first face transplant
Date: Fri, 2 Dec 2005 13:46:26 -0800 (PST)
Gives a whole new meaning to hockey's 'face-off'!
With Love,
CtrlAltDel aka Dave
C4/5 Complete - 29 Years Post
Texas, USA
[EMAIL PROTECTED] wrote:
William Willis spotted this on the Guardian Unlimited site and thought
you should see it.
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Note from William Willis:
Amazing!
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To see this story with its related links on the Guardian Unlimited site, go
to http://www.guardian.co.uk
Dog attack victim gets world's first face transplant
· Woman patient receives graft from deceased donor · French surgeons
perform procedure over two days
Jon Henley in Paris and Sarah Boseley
Thursday December 01 2005
The Guardian
Surgeons in France have performed the world's first face transplant, on a
38-year-old woman whose nose and lips had been torn off by a dog. The
complex, high-risk operation, which involved grafting on a triangle of
facial material from a deceased donor, was carried out over Sunday and
Monday at the University hospital in Amiens, the hospital said in a
statement yesterday.
It said the team of doctors for "the first partial face transplant" was led
by Professor Jean-Michel Dubernard, who performed the world's first hand
transplant at Lyon's Edouard Herriot hospital in 1998, and Professor
Bernard Devauchelle, head of maxillo-facial surgery at the Amiens hospital
in northern France.
The French team took the surgical world by surprise. Many had expected the
first face transplant to take place in the United States, after an
announcement in the summer that Cleveland clinic in Ohio had finally got
ethical approval and was about to start interviewing prospective patients.
But yesterday, Michael Earley, consultant plastic surgeon and a member of
the Royal College of Surgeons' working party on facial transplantation,
said that it was an operation waiting to happen.
"It could have been done anywhere where there are trained microsurgeons and
plastic surgeons - China, Australia or other countries - from a technical
point of view. What has been holding it back are ethical issues."
A team at the Royal Free hospital in London, under Professor Peter Butler,
has done extensive work modelling what a transplanted face would look like
- neither like donor nor recipient - and carrying out psychological
studies.
But, said Mr Earley, the ethical climate in the UK was not right. "I think
there would be a number of objections to it from experts in ethics and
psychologists and the general public," he said.
There were long-term risks of rejection, which would leave the patient
worse off than before. They would also have to take immuno-suppressant
drugs for life.
These risks had to be balanced against the benefit the patient would
receive. Inevitably, patients hoped for a better result than they might
get.
Nobody yet knew whether a transplanted face would look more natural than
reconstructive plastic surgery. The mobility of the new face would be in
question.
"Your brain moves your face in a particular way. It would still try to move
the transplanted face in the same way," said Mr Earley.
"A better looking face would be the object, but it seems likely that the
face would still not move in the normal way."
Neither French surgeon was available for comment yesterday. But Prof
Dubernard told Le Point magazine that he would give a full account of the
groundbreaking operation "with the whole team, and with the patient's
agreement, when the time is right to do so."
Le Point said relatives had given permission for the mouth-nose triangle of
skin, subcutaneous tissue, facial muscles and veins to be removed from the
donor on Sunday morning at a hospital in nearby Lille, shortly after she
was declared brain dead.
The operation then had to take place within 24 hours.
The unidentified recipient, who was savaged by a dog last May, had been
awaiting a suitable donor since August, when French health authorities
finally allowed her name to be added to a list of patients for
reconstructive surgery.
She has now reportedly been transferred to another nearby hospital for
further intensive treatment, including immuno-suppressant and
anti-rejection drugs that she will have to continue taking for life and
that carry considerable long-term health risks.
Authorities in France hesitated before giving the go-ahead because of the
"unusually high medical and psychological risks" associated with the
operation, Le Point said, citing the dangers of short and long-term
rejection of the transplant, and also the potential "ethical and
psychological" complications of living with somebody else's face.
UK experts welcomed news of the partial face transplant with some
ambivalence. "All medical advances are to be celebrated, but this operation
throws up many moral and ethical issues," said Iain Hutchison, consultant
facial surgeon at Barts in London and chief executive of Saving Faces, the
facial surgery research foundation.
"This was a 'quality of life' operation rather than a life-saving operation
and has many implications for the recipient and donor's families."
How it is done FAQ: What happens afterwards
Will a person who has a face transplant look like themselves, or like the
donor?
Somewhere in between. Such a person will have the donor's skin colour and
tone and texture, but their new face will mould to the person's underlying
bone structure. Nobody is quite sure, though, whether the transplant will
respond in a natural way to the patient's smile and other facial
expressions.
Is it a complex operation?
Not especially, as transplants go. The skin, fat, blood and connective
tissues are removed from the donor and laid over the recipient's bone and
muscle. The blood vessels are then connected. One surgeon said that it was
no more complex than sewing back a finger.
What are the long-term problems?
Formidable. To prevent their new face being rejected, a person would have
to take drugs to suppress their immune system for life. These drugs are
powerful and reduce the natural ability to fight infections. In addition,
there may be psychological problems. However much a person hates their
damaged face, it may be very hard to adjust to looking at what was once the
face of a stranger in the mirror.
Copyright Guardian Newspapers Limited
