A SURGEON is
preparing to conduct the world’s first full face transplant at a
hospital in Britain. Peter Butler, a consultant plastic surgeon at the
Royal Free hospital in Hampstead, north London, has already been
contacted by 29 disfigured volunteers willing to undergo the operation.
He is understood to have identified a 22-year-old man, whose face was
badly scarred in a house fire when he was 10, as a potential candidate.
Butler is awaiting the final go-ahead from his hospital’s ethics
committee to conduct the pioneering operation. He will present his
submission to the committee this week.
In 2003 Butler
planned to perform a face transplant on a 14-year-old Irish girl, but
the Royal College of Surgeons of England warned it was too early to
attempt the procedure and he cancelled his plan. Some critics believed
the risks were too great, while others pointed to the questions of
identity involved in transferring a face from one person to another.
However, last year’s successful partial face transplant on Isabelle
Dinoire, a French woman, has underlined the potential benefits of the
operation. Dinoire, 38, had her nose, lips and chin replaced after her
face was mauled by a dog. In a television interview last month Dinoire
said she was trying to return to a normal life and that she now had “a
face like everybody else. I hope this operation will help other people
too”.
Butler believes
Britain is ready for a face transplant that would relieve the
suffering of someone with such a serious disfigurement that he or she
feels unable to lead a normal life. “People have seen a woman with
severe facial deformity change to what looks like a perfectly normal
face,” said Butler. “It’s now not a case of how, in this country, but
when.”
The research ethics
committee at the Royal Free hospital will consider on Wednesday
whether to give Butler’s team final approval. If he receives
permission, he will begin to make his final selection. His team has
raised about £40,000 to fund operations on two patients.
Dr Michael Pegg, the
chairman of the ethics committee, said: “We are considering an
application to do a face transplant and want to make sure that the
procedures are followed perfectly. We will look at the application
very carefully before making a decision.” The committee has 60
days to consider the request, but this period can be extended if
further information is required. Pegg said yesterday that a Royal
College of Surgeons working party was also reviewing the issue, but
any advice it gave would not be binding. Butler and his 30-strong
team at the Royal Free have spent 10 years studying the clinical and
psychological aspects of face transplants. The ethics committee has
given him authority to seek patients for the operation.
“Selecting the right patient is very important,” said Butler. “It has
to be someone who can handle the psychological impact and has the
coping mechanisms to deal with the procedure.” Butler indicated
that one potential candidate was the 22-year-old, who was extensively
burned as a child. He said: “He has a mask-like effect on his face and
is missing his eyebrows. His muscles are working underneath but not
very well because the scar and the skin grafts are tethering. He also
has problems closing his eyelids and opening his mouth properly. So he
has the type of injury we are looking for.”
Other hospitals are
also hoping to perform the world’s first full facial transplant. A
medical team in Ohio was given the go-ahead last year, but is still
looking for a volunteer. Butler said yesterday: “My aim is not
to be first, but to do it on the right patient. It would be very
dangerous to look at it as a race because it could harm the patient
and (the reputation of) the procedure.”
Two teams of surgeons are involved during a face transplant operation.
One team removes the facial tissue of the donor from the hairline to
the jawline. The donor’s blood must be kept flowing artificially after
death to stop the face decaying. In a nearby theatre, the skin of the
transplant patient is detached. The blood vessels are clamped while
muscles and nerves are left in place.
The donor’s face is
stretched over the patient’s bone structure and face, then sewn into
place. The recipient must take immuno-suppressant drugs for the rest
of his or her life to stop the donor face being rejected. If the
patient’s immune system rejects the face, he or she will lose their
own face and that of the donor. |