Face Transplants Gaining Effectiveness
Doctors Say Experimental Surgeries Could One Day Become Routine
 Transplanting faces may seem like science fiction, but doctors say the experimental surgeries could one day become routine.
Two of the world's three teams that have done partial face
transplants reported Friday that their techniques were surprisingly
effective, though complications exist and more work is still needed.
"There is no reason to think these face transplants would not be as
common as kidney or liver transplants one day," said Dr. Laurent
Lantieri, one of the French doctors who operated on a man severely
disfigured by a genetic disease.
In Friday's issue of the British medical journal Lancet,
Lantieri and colleagues reported on their patient's status one year
after the transplant. Chinese doctors also reported on their patient,
two years after his surgery.
Last year, the French team operated on a 29-year-old man with
tumors that blurred his features in a face that looked almost
monstrous. They transplanted a new lower face from a donor, giving the
patient new cheeks, a nose and mouth. Six months later, he could smile
and blink.
The Chinese patient had part of his face ripped off by a bear.
Surgeons in Xian gave him a new nose, upper lip and cheek from a donor.
After a few months, he could eat, drink and talk normally, and returned
home to Yunnan province in southwest China.
The patients were not identified although photos were included in the reports.
As is the case with all transplants, doctors use immune-suppressing
drugs to prevent the recipient's body from attacking the donated
tissue. In both face transplants, the patients started rejecting the
transplanted tissue more than once. Their doctors solved the problem by
juggling their medications.
The French patient now takes three pills a day to prevent rejection.
"That's less than most people with diabetes," said Lantieri, a
plastic surgeon at the Henri Mondor-Albert Chenevier Hospital in
suburban Paris.
Other doctors were reassured by the results.
"To be able to wean down the dosage of the medication in small
amounts and relatively quickly, that is encouraging," said Dr. Bohdan
Pomahac, a plastic surgeon at the Brigham and Women's Hospital in
Boston.
Pomahac has permission to do a face transplant in the U.S., as do doctors at the Cleveland Clinic.
Experts have worried that if patients take lifelong anti-rejection
drugs after a transplant, their cancer risk will jump. Some also
predicted that rejection would destroy the face within a few years.
Those fears seem to have been allayed, Pomahac said.
With three successful partial face transplants so far - including
the world's first on a woman whose face was bitten off by a dog in
France - doctors say that some of the surgery's initial uncertainties,
like how functional the new face would be, are being answered.
For example, Lantieri's patient's face was paralyzed by tumors for
more than a decade. The French team wasn't sure if nerves could grow
after the transplant. But they discovered later their patient could
blink, proving the brain was able to restore long-forgotten facial
nerve connections.
Not everyone is convinced that face transplants are so revolutionary.
Dr. Patrick Warnke, a plastic surgeon at the University of Kiel in
Germany, calls them a "dead-end road," because he doesn't think the
rejection problem can be solved. Instead, he hopes to re-grow tissue
from patients' own stem cells.
Still, the biggest obstacle to more face transplants may not be scientific, but social.
"When kidney transplants first began, people were reluctant to
donate because there were a lot of cultural, social and religious
issues," Pomahac said. "This is exactly the same scenario now."
Doctors plan to do more face transplants, but are having a hard time finding donors.
"Everyone says they would accept a face transplant if they were
disfigured," Lantieri said. "The real question is, would you be a
donor, or would you allow your family member to donate their face? That
is the answer we need to change."
cbsnews.com
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