The dawn of face transplants

Filed in archive Treatment on July 25, 2005

Surgeons are getting ready to perform the first face transplant, as well as confronting the many questions about it:

The medical challenges to face transplantation are formidable. As Dr. Siemionow envisions it, the series of operations will require rotating teams of specialists who may be deployed in more than one operating theater. The face to be transplanted will be removed, or "degloved," from a cadaver; it will most likely include the epidermis, along with the underlying fat, nerves and blood vessels, but no musculature.

Surgeons also will remove the patient's own damaged facial tissue, then reattach the clamped blood vessels and nerves to the transplanted face. The procedures will take 15 hours, perhaps longer.

The months following may be even more harrowing. Patients receiving transplanted organs must take a lifelong regimen of drugs to suppress their own immune systems and prevent rejection. The drugs are expensive, often $1,000 per month, and the regimen does not always work. But even when it does, long-term immunosuppression increases the risk of developing life-threatening infections and cancer.

(Mason, "A New Face: A Bold Surgeon, an Untried Surgery", NY Times, Jul.26)