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Face Transplant at Cleveland Clinic Raises Ethical Questions

Posted by Jane Akre
Wednesday, December 17, 2008 10:00 AM EST
Category: Major Medical
Tags: FDA and Perscription Drugs, Cleveland Clinic, Transplant Surgery

Cleveland Clinic transplants a face using cadaver parts.


IMAGE SOURCE: WikiMedia Commons/ Nevit Dilmen 


In a marathon, still experimental surgery, a woman being treated at the Cleveland Clinic has had almost her entire face transplanted with skin and muscles harvested from a cadaver.

It’s the most extensive such operation ever performed and the first in the U.S., reports the Los Angeles Times.

The woman does not want her age and condition publicized. The donor’s identity has been kept confidential as well. Surgeons will only say that the patient was disfigured and about 80 percent of her face was replaced.

Dr. Maria Sieminow, a plastic surgeon, says that most people who want a face transplant have been extensively burned or in the case of a few procedures performed in Europe, were mauled by animals.

Sieminow and her colleagues at the Cleveland clinic have spent years practicing for the surgery, practicing on animals. So far about 50 patients would like to be considered for the procedure.

Dr. Maria Sieminow is a well known micro surgeon who specializes in hand surgery. She written a book on face transplants,“Transplanting a Face,” a memoir published last year.

In Europe, the first face transplant was performed in 2005 on Isabelle Dinoir, a 41-year old mother of two in France whose face was mauled by a Labrador dog.  She has since regained normal skin sensation and control of her facial muscles, reports the Washington Post.

However, recovery was difficult as her immune system reacted to the new tissue and she suffered kidney failure from the immune-suppressing drugs.

A man in France suffered from a genetic condition and another man in China had his face mauled by a bear.

The surgery is painstaking as each blood vessel must be grafted and muscles and skin attached onto the patient from the donor. The new face does not exactly match the donor because of the patient’s bone structure.

“You look more like a cousin” says Dr. James Bradley, a professor or plastic surgery at UCLA.

Waiting for a donor is one challenge since most donor families are already in shock and grief and may be reluctant to donate a visible part of the person.  

Patients must stay on rejection drugs for the rest of their life.  The Times reports that the immune-suppressant drugs have severe side effects and could shorten a patient’s life by as much as ten years. 

And if there are problems with the new tissue, medical ethicists are concerned that being forced to remove the face would create more problems than it attempted to solve. #

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