- The Washington Times - Wednesday, November 30, 2005

LYON, France — Doctors have performed the world’s first partial face transplant, grafting a nose, lips and chin onto a 38-year-old woman disfigured by a dog bite, hospital officials said yesterday.

The surgery was performed Sunday in Amiens in northern France by doctors from hospitals in Lyon and Amiens, according to a statement from medics at the hospitals.

Jean-Michel Dubernard, who collaborated in the transplant with Bernard Devauchelle, refused to discuss the case.

“We still don’t know when the patient will get out,” he said.

The hospitals said the woman, who wished to remain anonymous, was in “excellent” condition, and that the transplanted organs looked “normal.”

The woman was disfigured by a dog bite in May, and the injury made it difficult for her to speak and chew. The organs were taken from a donor who was brain-dead, with the family’s consent.

Specialists say the mouth and nose are the most difficult parts of the face to transplant. Doctors elsewhere have performed scalp and ear transplants.

Dr. Dubernard also led teams that performed a forearm transplant on a 49-year-old New Zealander in September 1998 and the first double arm transplant in January 2000 on Denis Chatelier, who lost his forearms when a model rocket he was trying to launch exploded.

Scientists around the world are working to perfect the technique involved in transplanting faces. The best treatments today still leave many people with freakish, scar-tissue masks that do not look or move like natural skin.

A complete face transplant, which involves applying a sheet of skin in one operation, has never been done before.

The main worry is that if the immune system rejects the transplant, the skin will slough off, leaving the patient worse off than before. Complications also could include infections that turn the new face black and require a second transplant or reconstruction with skin grafts.

Drugs to prevent rejection would be needed for the rest of the patient’s life, and they raise the risk of kidney damage and cancer.

Such concerns have delayed plans to attempt the operation in England.

In France, ethics authorities rejected an application by doctors to try the surgery last year but left the door open for partial transplants around the mouth and nose.

In the United States, the Cleveland Clinic is among those planning to try a face transplant. Maria Siemionow, a surgeon, said the clinic was “really looking for the right candidate,” whom she described as “severely disfigured patients which have already had the conventional treatment” and for whom a transplant is the last chance.

Doctors at Jinling Hospital in Nanjing, China, reported that they transplanted ears, part of the scalp and other facial skin from a brain-dead young man to a 72-year-old woman with advanced skin cancer in September 2003.

Four months later, there were no signs of rejection or tumor recurrence, but it is not known how the patient fared after that.

Doctors around the world have performed partial face transplants using the patients’ own skin, but those do not require anti-rejection drugs.

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