Doctors perform first partial face transplant

Life or death
A complete face transplant, which involves applying a sheet of skin in one operation, has never been done before. The procedure is complex, but uses standard surgical techniques.

Critics say the surgery is too risky for something that is not a matter of life or death, as regular organ transplants are.

The main worry for both a full face transplant and a partial effort is organ rejection, causing the skin to slough off.

“It is not clear whether an individual could be left worse off in the event that a face transplant failed,” said Dr. Stephen Wigmore, chair of the ethics committee of the British Transplantation Society.

Complications also include infections that turn the new face black and require a second transplant or reconstruction with skin grafts, perhaps even one or two years later. Drugs to prevent rejection are needed for life and raise the risk of kidney damage and cancer.

Such concerns have delayed British plans to attempt the operation. In France, ethics authorities rejected an application to try a full face transplant last year, but left the door open for a partial procedure involving the mouth and nose.

In the United States, the Cleveland Clinic is among those planning to attempt a face transplant.

The French surgery “doesn’t change our plans,” said Cleveland surgeon Dr. Maria Siemionow. “We are really looking for the right candidate,” which she described as “severely disfigured patients which have already had the conventional treatment” and for whom a transplant is the last chance.

Dubernard, who is also a lawmaker in France’s lower house of parliament, collaborated in the operation with the Amiens hospital’s Dr. Bernard Devauchelle. Weekly news magazine Le Point reported that the recipient lives in Valenciennes, in northeast France, and that the donor’s facial organs were removed in a hospital in Lille, about 60 miles from where the transplant was performed.

Dubernard also led teams that performed a hand transplant in September 1998 and the world’s first double forearm transplant in January 2000.

The hand transplant recipient, New Zealander Clint Hallam, later had it amputated. Doctors said he failed to take the required drugs and his body rejected the limb.

The double-forearm recipient, Denis Chatelier from France, said in 2003 that he had regained “normal usage” of his hands and was even able to shave himself. His forearms were severed in a model rocket accident.

Doctors from Jinling Hospital in Nanjing, China, reported that in September 2003, they transplanted two ears, part of the scalp and other facial skin from a brain-dead young man to a 72-year-old woman with advanced skin cancer.

Four months later, there were no signs of rejection or tumor recurrence, but it is not known how the patient fared after that.

Doctors around the world have performed partial face transplants using the patients’ own skin, but these don’t require anti-rejection drugs.

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