Face Transplant
Frequently Asked
Questions
What is a face transplant?
Could a face transplant be done
today?
What
expertise does the University of Louisville have in the area of face
transplants?
What are the surgical issues related
to human face transplants?
What are the immunological issues
related to human face transplants?
What are the ethical issues related
to human face transplants?
What research was done before
creation of the ethical guidelines?
Is the University of Louisville
planning to do a face transplant?
May I interview one of U of L’s
facial transplantation experts?
What is a
face transplant?
A face transplant is not
something that is aimed at cosmetic enhancement. Instead, this emerging
treatment is intended to give people with severe facial disfigurement better use
of facial features such as eyes and lips and a more normal appearance than can
be achieved through current reconstructive methods.
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Could a face
transplant be done today?
Physicians and scientists already
have the technical skills and experience to transplant a human face but they
also need to consider a wide array of ethical and psychosocial issues.
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What expertise
does the University of Louisville have in the area of face transplants?
U of L scientists, who have
conducted research in hand and face transplantation since 1995, organized the
first international symposium on composite tissue allotransplantation to discuss
barriers standing in the way of performing human hand transplants.
In 1998, a U of L research team
demonstrated that a blend of drugs widely used in organ transplants
effectively prevented skin and limb rejection in a pre-clinical animal model.
Aided by this discovery, U of L’s team as well as several other teams around the
world have performed more than 20 successful human hand transplants.
Louisville’s team performed the world’s first two successful hand transplants
1999 and 2001 at Jewish Hospital in Louisville.
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What are the
surgical issues related to human face transplants?
The surgical techniques used to
transplant a human face will be the same techniques used in current facial
reconstruction.
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What are the
immunological issues related to human face transplants?
The anti-rejection drugs used to
prevent facial tissue from rejecting will be the same drugs used successfully in
kidney, liver and more recently hand transplantation.
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What are the
ethical issues related to human face transplants?
Analyzing and evaluating the
ethical and psychological implications of face transplants is a central part of
U of L’s ongoing face transplant research program.
In 2004, U of L’s research team,
which includes scientists from Utrecht University in the Netherlands,
established ethical guidelines deemed critical to the success of the
still-untried procedure. These guidelines were outlined in an article in the
American Journal of Bioethics, “On the Ethics of Facial Transplantation
Research,” which was accompanied by critiques from more than a dozen leading bioethicists, psychologists and reconstructive surgeons.
“Open discussion of the ethics of
doing a face transplant is essential before it is performed,” said John Barker, team leader and U of L’s director of plastic surgery research.
“The hopes, anxieties and
emotional stability of organ transplant recipients have always posed ethical
concerns. These issues become even more critical in face transplant recipients,”
said Osborne Wiggins, a medical ethicist on U of L’s team. “At stake is a
person’s self-image, social acceptability and sense of normalcy.”
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What research
was done before creation of the ethical guidelines?
U of L’s research on the psychosocial issues in face
transplantation, begun in 2000, seeks to determine the perceived benefits and
risks of face transplantation and answer the key question: “Do the risks posed
by life-long immunosuppression drugs justify the benefits of receiving a new
face?”
Under the direction of U of L social psychologist Michael
Cunningham, professor of psychology in the U of L Department of Communications
and an internationally recognized expert in body image research, the team
developed and validated a questionnaire called the Louisville Instrument for
Transplantation (LIFT).
The questionnaire has been administered to more than 300
respondents from the following groups:
- Facially disfigured people (who might benefit from a
face transplant)
- Amputees (who might benefit from a hand transplant)
- Larynjectomy patients (who might benefit from a larynx
transplant)
- Organ transplant recipients (who have direct experience
living with the risks of immunosuppression)
- Healthy individuals (who have no direct experience with
the benefits or risks of transplants)
- Reconstructive surgeons (who care for facially
disfigured patients)
- Transplant physicians (who care for patients on
immunosuppression)
This
research is providine new objective data about the risks individuals are willing
to accept to receive a face transplant.
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Is the
University of Louisville planning to do a face transplant?
Currently, there is no effort to
identify, screen or recruit potential face transplant patients in Louisville.
Several milestones still need to be crossed before performing the procedure,
including:
- Selection of a hospital where the
transplant will be performed.
- Approval by an institutional review
board. Such boards are charged with considering issues related to patient
protection, safety and informed consent. At this time, U of L’s team has not
submitted a clinical protocol to an institutional review board in the United
States.
- Identification and training of a
full clinical team. This team would include head and neck reconstructive
surgeons, nurse coordinators; social workers, psychiatrists and psychologists;
operating room staff; a rehabilitation team (physical therapists, speech
therapists, occupational therapists and a patient advocate.
- Development of a facial tissue
procurement plan with an organ procurement organization and identification of
a facial tissue donor.
- Creation of a funding strategy to
pay for care of the first patients.
- Screening and recruitment of face
transplant recipients.
Since it is impossible to
predict how long these steps will take to complete,
it is impossible to project a time frame in which U of L’s team might perform a
face transplant.
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May I
interview one of U of L’s facial transplantation experts?
Because the University of Louisville team has no firsthand knowledge of the
procedure that has been done in France, our experts will not be providing
comments to the media or interviews at this time.
University of Louisville’s public
information policy can be found at
http://php.louisville.edu/advancement/ocm/public_info.php
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