Doctors detail face transplant

CLEVELAND, OHIO - December 17, 2008 - Only the woman's upper eyelids, forehead, lower lip and chin were left - the other 80 percent of her face was replaced with one donated from a cadaver.

The patient's name and age were not released, and the hospital said her family wanted the reason for her transplant to remain confidential.

It was the nation's first face transplant and the fourth worldwide.

"The surgery took 22 hours. The preparation to the surgery took over 20 years," said the lead surgeon, Dr. Maria Siemionow.

The woman's 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.

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," Siemionow said.

She said the woman is "doing well" and the surgery went according to plan.The transplant was done within the past two weeks.

"This patient exhausted all conventional means of reconstruction, and is the right patient," she said at a news conference.

So many disfigured patients are stuck "in their houses who are hiding from society," afraid to go out, she said.

"Our patient was called names and was humiliated," she said. "You need a face to face the world."

The face was donated by a family that asked specifically to approve the gift and was not done under general organ donation consent rules, said officials of LifeBanc, the Northeast Ohio organ procurement group that arranged the transplant.

The hospital posted a statement from the woman's sibling on its web site.

"We never thought for a moment that our sister would ever have a chance at a normal life again, after the trauma she endured," it says. "But thanks to the wonderful person that donated her organs to help another living human being, she has another chance to live a normal life. Our family cannot thank you enough."

Some medical ethicists question whether it's right to do a life-threatening surgery on someone to improve their appearance.

Dr. Allan Wulc is a local plastic surgeon- familiar with the Cleveland surgical team. He says rejection is a serious risk

Dr. Wulc told Action News, "Will the person have to have a lifetime of taking drugs that are immuno-suppressive, that have side effects and complications, a higher risk of infections, and possible a malignancy?"

Unlike operations involving vital organs like hearts and livers, transplants of faces or hands are done to improve quality of life - not extend it. Recipients run the risk of deadly complications and must take immune-suppressing drugs for the rest of their lives to prevent organ rejection, raising their odds of cancer and many other problems.

Siemionow considered dozens of potential candidates over the past four years, ever since the clinic's internal review board gave permission for her to attempt the operation.

The world's first partial face transplant was performed in France in 2005 on a 38-year-old woman who had been mauled by her dog. Isabelle Dinoire received a new nose, chin and lips from a brain-dead donor. She has done so astoundingly well that surgeons have become more comfortable with a radical operation considered unthinkable a decade ago.

Two others have received partial face transplants since then - a Chinese farmer attacked by a bear and a European man disfigured by a genetic condition.


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