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Dr. Jean-Michel Dubernard discussed facial transplants yesterday at Brigham and Women's Hospital. (Mark Wilson/Globe Staff) |
The New England Organ Bank has authorized a surgical team at Brigham and Women's Hospital to perform partial face transplants on eligible patients whose faces have been disfigured.
The team could perform an operation as early as the next few weeks, officials said, but it is unlikely a donor and recipient would be found for months, if not years.
To be eligible, recipients will have to be kidney transplant patients who have experienced facial burns, trauma, or skin cancer that has left them with "severe facial disfigurement," according to Sean Fitzpatrick, a New England Organ Bank spokesman.
Fitzpatrick said kidney transplant recipients are already taking immunosuppressive medication, which helps stop rejection.
Such patients have a higher risk of the development of facial cancers as a result of the medication.
The Brigham team is the first hospital in the United States to be authorized to perform such an operation.
"We want to be very careful and thoughtful about who we select as a patient," said Dr. Bohdan Pomahac, a plastic surgeon who heads the Brigham program.
"We want this to be successful. If something goes wrong, it could set us back 10 years."
Since the first partial face transplant in November 2005 was performed on a French woman mauled by a dog, only two other such transplants have been publicly disclosed - an additional operation in France and one in China.
Critics have questioned the need for such elective surgery, arguing it is unethical to risk the life of a patient for a nonlifesaving procedure.
Recipients will have to take powerful drugs so their immune systems do not reject the donor's tissue, which could expose them to infections and cancer.
But Pomahac and doctors in France say that partial face transplants will help people with severe facial deformities live more normal lives.
"This is not a life-saving operation; it's life-giving," Dr. Jean-Michel Dubernard, a member of the French surgical team that performed the 2005 operation, said while visiting doctors in the Brigham program yesterday.
"You give life by allowing them to reintegrate into society."
The surgery will not replace the entire face.
Transplants will include mostly the nose, lips, and a portion of surrounding cheek tissue. Recipients are unlikely to look like their donors.
"The underlying facial bones and muscle of the recipient will change the shape of the facial unit and largely determine its shape and final appearance," Fitzpatrick wrote in an e-mail.
He said the anonymity of the donors will be protected.
Pomahac said potential patients would undergo rigorous medical and psychiatric screening. He expects insurers will cover the costs of the procedure.
David Abel can be reached at dabel@globe.com.
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