June 19, 2006

Doctors Aim for First Full Face Transplant

By Peter Griffiths

LONDON (Reuters) - British doctors will seek approval for the world's first full face transplant from a hospital's panel this week, hoping to perform a ground-breaking operation which is likely to ignite a fierce ethical debate.

Surgeons at the Royal Free Hospital in north London are ready to perform the complicated operation but have yet to find a suitable patient.

"We have seen just under 30 people with severe facial injuries, but none of those is in the final assessment programme," a spokesman for the research team said on Monday.

"There are many more people to see."

Doctors have yet to perform a full face transplant, although two patients, in China and France, have had operations to replace part of their face.

Frenchwoman Isabelle Dinoire received a new nose, lips and chin last November after being mauled by her dog.

In April, a Chinese man attacked by a bear had two-thirds of his face replaced during a 14-hour operation, according to the Xinhua news agency.

Those operations sparked debate about the impact on the patient living with a dead person's face.

The hospital's committee meets on Wednesday to weigh up the psychological and ethical issues for the potential recipient and the donor's family.

The British team, led by surgeon Peter Butler, says the operation would give patients disfigured by accidents, burns or disease the chance of a normal life.


Critics say patients would struggle to cope with the immense psychological pressure of dealing with their new identity in the glare of the world's media.

Patients may be "highly distressed" by their new appearance and would worry that their body might reject the transplant, according to a report by the Royal College of Surgeons of England published in 2003.

The drugs needed to stop the body rejecting the new face can cause complications such as skin cancer, it said. The procedure is so complicated that patients may be unable to give informed consent.

The British team has said the donor's face would be unrecognizable after transplant due to different bone structure.

Various research teams are looking at carrying out the world's first full facial transplant in what has been dubbed the "Face Race."

The charity Changing Faces, which helps people with disfigurements, said the transplants raised difficult ethical, psychological and technical questions.

"It would be unwise to proceed at speed," a spokeswoman said. "We want some answers to some of these questions."

The Department of Health said it was a matter for the hospital's ethics committee. The hospital declined to comment ahead of the meeting.

The committee may take up to two months to reach a decision and more hearings may be needed when candidates for surgery are found, Butler's spokesman said.