Face transplant

from Wikipedia, the free encyclopedia

A face transplant is a transplant that involves replacing part or all of a patient's face with that of a dead donor . It is therefore a composite tissue allograft . In extreme cases, bone parts can also be transplanted from the donor's skull.

purpose

This operation could help people whose face is disfigured by accidents (e.g. burns ), injuries, illnesses or malformations .

Alternatives

As an alternative to a face transplant, a series of surgical procedures involves removing the patient's own skin from the back, buttocks or thighs and transferring it to the face. However, success is often limited, both in terms of physical functions and looks. Often times a face restored in this way retains a strongly “mask-like” appearance. The great advantage of this method, however, is that no foreign tissue is used. Extensive immunosuppressive measures , some of which can have considerable side effects such as serious infections, cancer and others, can therefore be completely dispensed with.

history

In November 2005, the French doctors Jean-Michel Dubernard (who also performed the first successful hand transplant in 1998 ) and Bernard Devauchelle carried out the world's first face transplant on a living person in Amiens . The patient was Isabelle Dinoire , 38 , whose face was disfigured by her dog's attack. She had part of her left cheek and nose, as well as her chin and lips. In October 2008 she assessed the healing process so far as positive: “This face is mine,” she said literally.

The second face transplant was performed in 2006 on a Chinese man who had been attacked by a bear; In 2007, another French man was operated on who was suffering from the effects of a previous operation to remove a facial tumor.

In December 2008, the largest face transplant to date, and the first in the United States, was performed at the Cleveland Clinic in Cleveland, Ohio, by surgeon Maria Siemionow . In 2004, the clinic was also the first in the world to have such a procedure approved. During the operation , about 80% of the face of Connie Culp , a patient who was injured with a gun by her husband, was transplanted.

In March 2010, Spanish doctors succeeded in transplanting a complete face for the first time worldwide. The transplant was performed in a 22-hour operation in the Vall d'Hebron hospital in Barcelona and, according to the doctors, should have been successful. The patient is a young man whose face is said to have been so severely disfigured by injuries that he was barely able to breathe, swallow and speak.

The first full face transplant in the US was performed in March 2011. The 15-hour operation that was performed at Brigham and Women's Hospital in Boston went great. Two years earlier, the 25-year-old patient from Dallas Vienna had been caught in a power line while working, which severely disfigured his face from severe burns.

Operation and follow-up treatment

The operation consists of a series of interventions that require several teams of specialists. After considering the patient's skin type, age, gender and skin color, the patient's face is removed and replaced with that of the (dead) donor - including fatty tissue , nerves and blood vessels , but without the muscles .

The operation takes about 8 to 15 hours, followed by a 10 to 14 day inpatient hospital stay.

After the procedure, lifelong treatment with immunosuppressive drugs is required to prevent the patient's immune system from rejecting the foreign tissue. Long-term suppression of the immune system increases the risk of life-threatening infections , kidney damage and cancer (see also the section on immunosuppressive therapy under transplantation ). As a result of the operation, complications such as infectious diseases can occur, which turn the new face black and necessitate further interventions. Psychological consequences can include the regret of the operation on the part of the patient, disappointment with the result or feelings of grief and guilt towards the donor.

The appearance of the patient after the transplant does not correspond to that of the donor, since the shape of the face is also determined by the muscles and bone structure that are not transferred. The new face will not correspond to the previous, undamaged face either, but will lie somewhere between the two original faces. It should also be remembered that this procedure is a difficult plastic surgery , the outcome of which can never be predicted with certainty.

Treatment of the subject in the film

  • Georges Franju describes the process of a face transplant in his horror - cult film Eyes Without a Face 1960 in a very grotesque, yet reasonably accurate way.
  • The theme also plays a central role in John Woo's 1997 action film In the Body of the Enemy .
  • In season 3, episode 9 ( Hannah Tedesco ) of the US series Nip / Tuck (2003-2010), a face transplant is performed.
  • In the episode Bob Next Door (2010/2011) from the animated series The Simpsons , the villain Tingeltangel-Bob undertakes a face transplant in order to be released from prison.
  • Grey's Anatomy; Season 5, Episode 18 (The Man in the Woods)
  • The Good Doctor; Season 2, Episode 14 (Faces "Faces")

See also

Individual evidence

  1. ^ Brian Gander, Charles S. Brown, Dalibor Vasilic1, Allen Furr, Joseph C. Banis Jr, Michael Cunningham, Osborne Wiggins, Claudio Maldonado, Iain Whitaker, Gustavo Perez-Abadia, Johannes M. Frank and John H. Barker: Composite tissue allotransplantation of the hand and face: a new frontier in transplant and reconstructive surgery , August 18, 2006, In: Transplant International , November 2006. doi : 10.1111 / j.1432-2277.2006.00371.x
  2. ↑ A picture of the transplanted face part (scheme)
  3. ↑ a b Christina Berndt: "The face of others" , article from December 18, 2008 on sueddeutsche .de, accessed on May 10, 2009.
  4. ↑ Michael Mason, “A New Face: A Bold Surgeon, an Untried Surgery,” July 26, 2005 article in the New York Times , accessed May 10, 2009.
  5. ↑ Ron Winslow, “Face-Transplant Patient Emerges,” May 6, 2009 article on the Wall Street Journal website , accessed May 10, 2009.
  6. ↑ World's first complete face transplant . Archived from the original on February 16, 2014.
  7. ↑ For the first time complete face transplanted in USA  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. , heute.de of March 21, 2011@1@ 2Template: Toter Link / www.heute.de  
  8. ↑ http://simpsonspedia.net/index.php?title=Bob_von_nebenan Bob next door, http://simpsonspedia.net , version of the page from September 4, 2013. Accessed May 26, 2015.

Web links

French

English

Article about the first patient after the operation:

German