Organs: Facial Transplantation May Be Safer Than Thought

Immunosuppressive risks associated with facial transplantation may be lower than thought. Fever than ten percent of patients would experience chronic rejection over five years.29/08/2007

The first recorded facial transplant was performed in France in 2005 on a 38-year-old woman whose nose, lips and chin had been bitten off by a dog. Tissues, muscles, arteries and veins were taken from a brain-dead donor and successfully transplanted to the patient’s lower face.

There have been only two similar attempts since. In 2004, the British Royal College of Surgeons published a controversial report predicting a high incidence of immunological complications for facial transplants. This data became a benchmark for facial transplant teams and review boards and greatly influenced the facial transplantation debate.

According to Steve Woodle, MD, of the University of Cincinnati, however, the report did not provide the best risk assessment. Both the health status of solid organ transplant recipients and the tissue composition of the solid organs reported in the earlier studies are very different from that of face transplant recipients and their facial tissues, he says. In the current study, the researchers compared the 2004 data with that taken from clinical studies describing kidney and hand transplants using the latest immunosuppression techniques.

They found the outcomes to be very different from those in the 2004 study. Based on kidney and hand transplantation cases, in which the same drug regimen was used, researchers found that acute, or immediate, rejection may occur in ten to 70 percent of patients. Of all these cases, however, rejection was reversible by adjusting the immunosuppression medications.

They also found that fewer than ten percent of patients would experience chronic rejection over five years. “In considering the most recent and relevant data, we came to the conclusion that the expectations for face transplant recipients should be significantly better than those previously published,” Woodle says.

Source: University of Cincinnati