Face Transplants Show Promising Results

Thursday, August 21, 2008; 7:19 PM

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THURSDAY, Aug. 21 (HealthDay News) -- Two cases of face transplantation demonstrate the procedure can be used for long-term restoration of serious facial disfigurement.

The first case involves a 30-year-old Chinese man who had part of his face torn off in a bear attack in October 2004. In April 2006, the man underwent transplantation that included connection of arteries and veins, along with repair of the nose, lip, sinuses and other damaged facial structures.

The man received four different drugs to modulate the immune system and decrease the chances of tissue rejection, along with drugs to prevent infections. There were episodes of acute tissue rejection at three, five and 17 months after transplantation. These were controlled by dose adjustment of one of the immunomodulatory drugs or by use of a steroid.

The man's kidneys and liver functioned normally, and he had no infections.

"Facial transplantation could be successful in the short term, but the procedure is not without complications... This case suggests facial transplantation might be an option for restoring a severely disfigured face and could enable patients to readily integrate themselves back into society," concluded Shuzhong Guo, of the Institute of Plastic Surgery, Xijing Hospital and Fourth Military Medical University in Xi'an, and colleagues.

The case report was published in this week's issue of The Lancet.

The second article describes a 29-year-old male patient in France with a seriously disfiguring facial tumor called a neurofibroma that had infiltrated the middle and lower part of his face.

His transplantation surgery in January 2007 -- meant to restore both appearance and function to his face and to help him regain the ability to communicate and socialize -- involved removal of a large part of his face and replacement with donor tissue.

The patient experienced episodes of tissue rejection 28 and 64 days after the transplant, but both episodes were successfully managed by doctors. One year after the surgery, sensation and motor function had returned in the transplanted area.