French Doctors Defend Ethics of First Face Transplant

Physicians in Amiens grafted part of a face onto a disfigured woman Sunday.
Physicians in Amiens grafted part of a face onto a disfigured woman Sunday. (Associated Press)
By John Ward Anderson
Washington Post Foreign Service
Saturday, December 3, 2005

LYON, France, Dec. 2 -- French physicians on Friday defended their decision to perform the world's first partial face transplant on a 38-year-old woman, saying horrific wounds from a dog bite in May probably could not have been repaired through conventional reconstructive surgery and had left her largely unable to eat, drink or talk.

When the woman first saw her new face on Monday, "she said, 'Thank you very much,' " Bernard Devauchelle, a microsurgeon and one of the chief physicians on the transplant team, said at a news conference.

"She was very happy, compared to what she used to have," added Jean-Michel Dubernard, a transplant specialist who was co-leader of the team. The woman has requested that her name be withheld.

News of the operation brought criticism from some medical ethicists, who questioned whether a high-risk transplant should be performed for cosmetic reasons on patients who do not have life-threatening injuries. There also are potential psychological ramifications for patients in swapping one of the most personal and individual features of a body, which for many people is a reflection of persona.

At the news conference, members of the medical team reported that the woman was in stable condition at Edouard Herriot Hospital in Lyon, 285 miles southeast of Paris. Her body so far has shown no signs of rejecting the new face, one of the biggest risks in the procedure, they said.

Two medical teams totaling about 50 people performed the procedures in a hospital in Amiens, about 70 miles north of Paris, near the patient's home. The work began at about 10:30 p.m. Saturday with the removal of a triangular patch of face from a brain-dead woman -- including her nose, lips and chin. The final grafting onto the recipient concluded at about 4 p.m. Sunday, the doctors said.

No bones were transplanted during the operation, which involved muscles, cartilage, skin, arteries, veins and nerves.

The patient was moved this week to a hospital here in Lyon for long-term observation and therapy. Doctors said she was starting to stretch and exercise the muscles of her new face, was able to talk coherently and was beginning to eat and drink without assistance.

They said it would be about six months before she regained fuller sensitivity in her face, although "the risk of rejection will last for a lifetime," Devauchelle said.

Surgical teams in the United States and Britain have been preparing to conduct face transplants for several years, but in addition to the technical challenges, the operations have been delayed by ethical considerations.

The French physicians said they expected some criticism and questions about the ethics of the operation. Dubernard ran into similar controversy in 1998 when he performed the first hand transplant. Three years later, the patient had the hand amputated. His physicians said he had failed to take the necessary drugs and follow the proper therapy, and so his body rejected the hand.

At the news conference Friday, team members denied rushing into the facial operation in order to claim a medical first. It was "an exceptional situation triggering an exceptional solution," said Philippe Domy, director general of Amiens University hospital.

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