First full face transplant waits for the green light

Jun 19 2006

If a top London hospital gets the green light from its ethical committee, the world's first full face transplant may very well be carried out in Britain.

The ethical committee of the Royal Free Hospital in London will meet this week to make a decision over the landmark procedure, and if permission is granted a selection process will begin.

That process in itself could take all of a year for a suitable candidate to be identified.

The approval is expected to given.

Professor Peter Butler a top plastic surgeon at Royal Free, has led a team of plastic surgeons and specialists at the hospital who have spent over 12 years researching the procedure and have already reviewed possible patients.

For the last five years they have been doing research into tissue rejection and psychological issues as well as concerns regarding identity.

The ethical committee will apparently consider the form of the operation and whether it is appropriate to sanction such surgery.

A suitable patient must then be found and permission sought for that person to be operated on.

Falklands veteran Simon Weston, who suffered horrific burns in the 1982 Falklands war will accompany the medical team to the meeting to explain why he thinks doctors should be allowed to perform face transplants.

Last November a 38-year-old French factory worker, Isabelle Dinoire, became the first person to receive a new face which was donated by the family of a suicide victim.

It took a team of 50 medical personnel in Amiens, northern France, who worked around the clock, to perform the transplant.

Ms Dinoire was mauled by her labrador and received a partial transplant, she now has feeling back in her face and says her life has been transformed.

She received a section of nose, lips and chin in a partial face transplant carried out by a team of surgeons led by Professor Jean-Michel Dubernard.

Dinoire still receives an anti-rejection treatment every week and medication every day entailing ten different pills.

She must also examine a small patch of skin from the donor attached to her stomach several times each day that will alert her if the tissue is being rejected.

The Royal College of Surgeons has been reticent about the surgery and produced a report last year which concluded that more research was needed to show that a new, donor face transplanted on to a patient would not be rejected by the body's immune system.

The team at the Royal Free have carried out studies that demonstrate that a transplant is not only physically possible but would have huge psychological benefits for people left disfigured by accidents or burns.

Professor Butler says the decision this week will hopefully represent a final breakthrough.

He has already been given permission to carry out different aspects of the preparatory work, including talking to potential patients to assess their psychological state.

Butler has asked permission to select four or five people give scientific validity to the surgery and to ease the inevitable media pressure on the patients.

They have apparently already interviewed 29 potential candidates and asked them how they feel about their appearance and how they would feel about taking on the face of a donor, but the first four patients will not necessarily be taken from this group.

The surgery will require the removal of eight different blood vessels, four arteries and four veins from the donor and attaching them to the patient's face by reconnecting the tissue.