World's First Partial Face Transplant

French surgeons have carried out the first partial face transplant, using material from a brain-dead donor to rebuild the face of an anonymous 38-year-old woman who lost her nose, lips, and chin when attacked by her pet Labrador.

A surgical team led by Professor Bernard Devauchelle, of Amiens University Hospital (France), and Professor Jean-Michel Dubernard, of Edouard-Herriot Hospital in Lyon (France), carried out the five-hour operation in Amiens in early December 2005. No bones were transplanted during the operation, which involved the use of muscles, cartilage, skin, arteries, veins and nerves to create a "hybrid” face, so that the patient would not completely resemble the donor.

The patient has reportedly been transferred to a hospital in Lyon for a period of four to six weeks, where she will receive further intensive treatment. Doctors said she was starting to stretch and exercise the muscles of her new face, was able to talk coherently, and was beginning to eat and drink without assistance.

The woman had an infusion of bone marrow stem cells from the donor in a second operation several days later and is scheduled to have a second such procedure. The doctors hope that the marrow transplant, an experimental procedure, will help the patient's immune system adapt to her new face and lower the chances of her body rejecting it.

The patient will be put on a protocol including immuno-suppressant and anti-rejection drugs that she will have to continue taking for life and that carry considerable long-term health risks. Among these risks is the chance that the graft will be rejected, leaving the patient in a worse condition than before the operation, the development of cancer from the immunity suppressing drugs given to prevent organ rejection, and the chance that the patient will suffer major psychologic problems in adjusting to a new appearance.

Professor Dubernard led teams that performed a hand transplant in 1998 and the world's first double forearm transplant in 2000. At the press conference on December 2, 2005, team members denied rushing into the facial operation in order to claim a medical first.

In September 2005, Dr. Maria Siemionow, director of plastic surgery at the Cleveland Clinic (OH, USA), noted that she wanted to be the first surgeon in the world to complete a face transplant. "I hope nobody will be frivolous or do things just for fame. We are almost over-cautious,” she said at the time. The clinic declined to comment on the French case.




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Amiens University Hospital