Early online publication: Tuesday July 4, 2006. EMBARGO: 00:01H (London time) Tuesday July 4, 2006. In North America the embargo lifts at 18:30H ET Monday July 3, 2006.
French researchers responsible for the recent human face transplant report their 4-month results in a paper published online today (Tuesday July 4, 2006) by The Lancet.
On November 27, 2005 Bernard Devauchelle (Centre Hospitalier Universitarie Amiens, Amiens, France) and colleagues transplanted the central and lower face of a brain-dead woman onto a 38-year-old woman whose nose, upper and lower lips, chin, and adjacent parts of her right and left cheeks had been amputated after a severe dog bite. The researchers describe the detailed process that took place before, during, and after the transplantation in their paper. Their technique achieved an aesthetic outcome better than that possible from conventional methods. The patient also regained the ability to chew food and an improved ability to speak.
Professor Devauchelle concludes: "The 4-month outcome demonstrates the feasibility of this procedure. The functional result will be assessed in the future, but this graft can already be deemed successful with respect to appearance, sensitivity, and acceptance by the patient."
In an accompanying Comment, also published online today, Patrick Warnke (University of Kiel, Germany) hails the result as a 'new milestone'. He states that the functional and aesthetic result is superior to common techniques, but warns of the potential problems: "The aim of all of our efforts as surgeons, clinicians, and scientific innovators is to improve the quality of life and realise the wishes of our patients. This aim has been achieved by Devauchelle and colleagues with a degree of success that was likely not anticipated by either their appreciative patient or by the medical community at large." He adds: "The allotransplantation technique mandates substantial lifelong immunosuppression to prevent rejection. Failure of the regimen chosen could prove devastating, with the possible loss of the transplanted face at any time…Substantial immunosupression also increases the patient's vulnerability to infection or the development of malignancies."
In another Comment published online today, Thomas Pradeu (Sorbonne University, Paris, France) and Edgardo Carosella (Hopital Saint-Louis, Paris, France), focus on the ethical issues raised by technique.
Contact:
Professor Bernard Devauchelle PHD MD FRCDS, University Hospital, Departement of Maxillofacial Surgery, HOPITAL NORD, Place Victor Pauchet, AMIENS, 80054, France. T) +33 322 668 328 devauchelle.bernard@chu-amiens.fr
Dr Patrick H Warnke, Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Heller-Str 16, 24105 Kiel, Germany. T) 49 431 597 2821 warnke@mkg.uni-kiel.de
Journal
The Lancet