Nation's First Face Transplant Done in Cleveland

The nation's first near-total face transplant has been done on a
woman at the Cleveland Clinic, the hospital announced Tuesday.
Reconstructive surgeon Dr. Maria Siemionow replaced nearly all
of the woman's face - 80 percent - with that of a dead female donor
in an operation a couple weeks ago.
The patient's name and age were not released. The hospital plans
a news conference Wednesday and would not give details until then.
The world's first partial face transplant occurred in France
three years ago on a woman who had been mauled by her dog. Two
others have been announced since then - a Chinese farmer attacked
by a bear and a European man disfigured by a genetic condition.
The nature of the injuries or disfigurement that prompted the
Cleveland case are not yet known. Such transplants are
controversial, because they are aimed at improving a patient's
quality of life rather than saving it, and require recipients to
take immune-suppressing drugs for the rest of their life.
"It is very important what kind of recipient they selected,"
and how great the need was, said Dr. Bohdan Pomahac, a surgeon at
Harvard-affiliated Brigham and Women's Hospital in Boston, which
plans to offer face transplants too.
"There are patients who can benefit tremendously from this,"
he said. "It's great that it happened. It is a major move forward.
Hopefully it will open the door both to the public and to other
centers" wanting to offer such transplants, Pomahac said.
Burn and severe trauma patients have long needed better options,
but "the ethics are really controversial" for face transplants,
said Dr. Jeffrey Guy, director of the Burn Center at Vanderbilt
University.
For the doctors in Cleveland, the task now is balancing two
medical risks: the need to give strong immune suppression drugs to
prevent rejection, and managing the risk of infection increased by
taking such medicines.
Rejection is a possibility whenever someone receives an organ or
cells from someone else because the body regards this as foreign
tissue. Two types of problems can result.
The first is graft-versus-host disease, which happens if the new
facial tissue were to attack the body of the recipient (the host).
The second is if the transplant recipient's body were to attack the
marrow or the transplanted face, causing inflammation and other
problems at the site of the new tissue.
Either of these can be life-threatening. They can come on
suddenly, within days or weeks of the operation, a situation called
acute rejection. Or chronic, low-level rejection can set in and
slowly undermine the recipient's health.
---
On the Net:
Cleveland Clinic: http://www.clevelandclinic.org

(Copyright 2008 by The Associated Press. All Rights Reserved.)
The nation's first near-total face transplant has been done on a
woman at the Cleveland Clinic, the hospital announced Tuesday.
Reconstructive surgeon Dr. Maria Siemionow replaced nearly all
of the woman's face - 80 percent - with that of a dead female donor
in an operation a couple weeks ago.
The patient's name and age were not released. The hospital plans
a news conference Wednesday and would not give details until then.
The world's first partial face transplant occurred in France
three years ago on a woman who had been mauled by her dog. Two
others have been announced since then - a Chinese farmer attacked
by a bear and a European man disfigured by a genetic condition.
The nature of the injuries or disfigurement that prompted the
Cleveland case are not yet known. Such transplants are
controversial, because they are aimed at improving a patient's
quality of life rather than saving it, and require recipients to
take immune-suppressing drugs for the rest of their life.
"It is very important what kind of recipient they selected,"
and how great the need was, said Dr. Bohdan Pomahac, a surgeon at
Harvard-affiliated Brigham and Women's Hospital in Boston, which
plans to offer face transplants too.
"There are patients who can benefit tremendously from this,"
he said. "It's great that it happened. It is a major move forward.
Hopefully it will open the door both to the public and to other
centers" wanting to offer such transplants, Pomahac said.
Burn and severe trauma patients have long needed better options,
but "the ethics are really controversial" for face transplants,
said Dr. Jeffrey Guy, director of the Burn Center at Vanderbilt
University.
For the doctors in Cleveland, the task now is balancing two
medical risks: the need to give strong immune suppression drugs to
prevent rejection, and managing the risk of infection increased by
taking such medicines.
Rejection is a possibility whenever someone receives an organ or
cells from someone else because the body regards this as foreign
tissue. Two types of problems can result.
The first is graft-versus-host disease, which happens if the new
facial tissue were to attack the body of the recipient (the host).
The second is if the transplant recipient's body were to attack the
marrow or the transplanted face, causing inflammation and other
problems at the site of the new tissue.
Either of these can be life-threatening. They can come on
suddenly, within days or weeks of the operation, a situation called
acute rejection. Or chronic, low-level rejection can set in and
slowly undermine the recipient's health.
---
On the Net:
Cleveland Clinic: http://www.clevelandclinic.org

(Copyright 2008 by The Associated Press. All Rights Reserved.)


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