From Our 2008 Archives

1st U.S. Face Transplant Patient Recovering

Patient Is "Doing Well" and Shows No Sign of Tissue Rejection, Her Doctors Say

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

Dec. 17, 2008 -- The woman who recently got the first face transplant in the U.S. is "doing well," her doctors at the Cleveland Clinic said at a news conference today.

The woman, who wishes to remain anonymous, had 80% of her face replaced within the last two weeks with facial tissue from a deceased donor. The patient had suffered severe facial trauma several years ago, leaving her blind in one eye and without a nose or upper jaw.

The patient is recovering at the Cleveland Clinic and hasn't shown any signs of tissue rejection, says Maria Siemionow, MD, PhD, director of plastic surgery and head of microsurgery training at the Cleveland Clinic.

The patient hasn't seen her still-swollen face yet, but she has run her hands over it and is "happy" that she now has a nose, jaw, and a "full face," Siemionow says.

About the Face Transplant Patient

The patient's doctors won't say what had caused the patient's facial trauma. She had already tried conventional reconstruction and suffered because of how people treated her.

"She was called names and children were afraid of her," says Siemionow, calling the woman "brave."

Few other details about her have been released, except that she's a U.S. citizen, and that she wanted the operation not only for herself but to pave the way for other people like her. No images of the patient are being released, in keeping with her and her family's wishes.

Few details are available about the donor, except that she's a woman. Donors have to match the patient's gender, race, approximate age, and blood type.

About the Face Transplant Operation

The operation took 22 hours and involved replacing most of the woman's face, except for her upper eyelids, forehead, lower lip, and chin. That meant working with layers of tissue -- skin, muscles, bones, arteries, veins, and nerves.

It took four years to find the right patient and donor, and 20 years of work on techniques leading up to the surgery, Siemionow notes.

What's Next for Face Transplant Patient

The patient will need to take immune-suppressing drugs for the rest of her life to help prevent her body from rejecting the donated tissue.

The Cleveland Clinic predicts that the patient's facial swelling will ease in a few months, that she'll get feeling in her face within the next six months or so, and that about a year from now, most of her face should be functional.

She won't look like her donor.

"Even though some bone was transferred from the donor to the recipient, the underlying facial structure of any two people is very different," states a Cleveland Clinic fact sheet about the face transplant.

More Face Transplants Ahead?

Siemionow says her team has gotten a grant from the U.S. Department of Defense and is evaluating severely disfigured veterans who might be candidates for the procedure.

The procedure is risky. There's the risk of tissue rejection, the lifelong need for immune-suppressing drugs, and the possibility that if the transplant doesn't take, a patient might need to undergo a skin graft using skin from their own body. Patients also need to be psychologically stable, resilient, responsible, and self-reliant, and to have exhausted all other treatment options, notes the Cleveland Clinic.

Previous Face Transplants

In 2005, French doctors reported performing the first human face transplant on a woman whose face had been severely injured by dog bites. In December 2007, those doctors said the results from the woman's partial face transplant were "satisfactory."

In August 2008, The Lancet published reports of two other patients who got partial face transplants. One of those patients was a man in China who had been mauled by a bear; the other patient was a man in France whose face had been disfigured by a tumor.

SOURCES: Maria Siemionow, MD, PhD, director of plastic surgery and head of microsurgery training, Cleveland Clinic. News release, Cleveland Clinic. WebMD Health News: "First Face Transplant Patient Doing Well." WebMD Health News: "Face Transplant Patients Make Progress."

©2008 WebMD, LLC. All Rights Reserved.





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