Green signal to full face transplant

After the most detailed scrutiny that lasted more than ten years, UK’s Face Transplantation team at the Royal Free Hospital in London finally got a formal go-ahead from the hospital's Research Ethics Committee on Wednesday.

To begin with, the team of British surgeons being led by Dr. Peter Butler will perform four surgeries.

Delighted over been given the permission for the pioneering surgery Dr. Butler said, “We can now begin to evaluate patients and draw up a shortlist of four people who want to undergo this procedure”.

A face transplant is a skin graft that involves replacing part or all of a patient's face with a donor face.

The world's first partial face transplant was performed in November 2005 by a team of surgeons led by Professor Jean-Michel Dubernard and Professor Bernard Devauchelle in Amiens, France.

Isabelle Dinoire underwent the surgery to replace her original face that had been ravaged by her dog. A triangle of face tissue from a brain-dead human's nose and mouth was grafted onto her.

The permission to perform a full face transplant raises hopes for people distressed with severe facial disfigurement caused by burns, disease or birth defects.

Under the surgery, the skin and muscle tissue along with eight different blood vessels, four arteries and four veins will be taken from a brain dead donor patient’s face.

These blood vessels and nerves will then be reconnected with the recipient’s face using micro vascular surgery, with recipient being put onto immuno-suppressant drugs to prevent rejection of the new tissue.

Expertise of four to six surgeons will be required in each set of transplant that is likely to last 10 to 12 hours. Then operations will be carried out at six month intervals to assess the procedure.

Conversely, authorities warned patients to be completely aware of the risks linked to immuno-suppressant drugs, including the possibility of rejecting the new tissue, and the need for a ‘Plan B' if the operation was unsuccessful.

However, the announcement sparked an ethical debate and raised questions about the psychological impact of the procedure on both the recipient and the donor's family.

Critics, especially the Royal College of Surgeons' training body preferred if the ethics committee had waited until the RCS recommendations on minimum requirements to be fulfilled before transplantation could take place were published next month.