Face Transplant Performed in Cleveland

Surgeons at the Cleveland Clinic have performed the first face transplant in the United States and the fourth in the world on a woman. A team led by reconstructive surgeon Maria Siemionow replaced about 80 % of the woman's face with skin and muscle harvested from a cadaver.

The clinic refused to divulge any details on the identity of either the deceased female donor or that of the female recipient. Eileen Sheil, a spokeswoman said, "The patient's information will remain confidential, as will the donor's information." The patient's family has asked for her name and age to be kept anonymous.

A new conference has been scheduled in which the clinic plans to release more information on the procedure which was far more extensive than the ones performed previously in France and China. "We call it a near-total face transplant. It was substantially more involved than what's been done to date," Sheil said.

Facial transplants are controversial because many critics question if they are ethical as they are not to save a life but to improve the quality and powerful immune suppressing drugs have to be taken for the rest of the life.

Dr. Maria Siemionow, the Cleveland Clinic plastic surgeon who performed the procedure, spent years preparing for the surgery, practicing on animals and doing trial runs on 20 cadavers, said Dr. James Bradley, a professor of plastic surgery at UCLA Medical Center.

Dr. Warren C. Breidenbach of the University of Louisville, who performed the first hand transplant in the United States said, "We're on the threshold of a whole new way of correcting defects."Hand transplants have been performed earlier along with a larynx and a tongue transplant.

Surgeons said transplanting a face isn't any more of a technical feat than transplanting a hand, though it has a unique set of complications. Siemionow said, "Those who suffered extensive damage to their faces would forever be socially crippled in a society that appears to value beauty above all other human characteristics."

Face transplants are tricky in areas other than the procedure itself. "You have to wait for a donor, and that's not easy," Breidenbach said. "A lot of donor families are in shock and grief because their loved one died and they have to donate a very visible part of the person." To find a patient is also just as difficult as they need the right type of psychological profile and candidates for the surgery at Cleveland Clinic "undergo evaluation by the most rigorous clinical and psychological examinations devised," Siemionow wrote.

Bradley said it could take months before the nerves have healed enough to gauge the success of the procedure. Carson Strong, a professor of human values and ethics at the University of Tennessee College of Medicine said, "One case is merely an anecdote. It doesn't create a scientific basis to say it's safe for a patient to do this." Several other U. S. hospitals are considering similar operations.


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