Partial Face Transplant
AP reports that the first partial face transplant has happened in France, of course, leaving the good people of Cleveland and Louisville to compete for the first whole-face (is that even a coherent term?) transplant. We've followed this since the whole business started, including the first major collection about the ethical issues for it. Worth checking out just for the dopey puns. Anyway here's the scoop:The hospitals’ statement said the woman was in “excellent” condition, and the transplanted organs looked “normal.” She wants to remain anonymous, the statement added.The woman was disfigured by a dog bite in May, and the injury made it difficult for her to speak and chew, the statement said. Such injuries are “extremely difficult, if not impossible” to repair using normal surgical techniques, it added.
The organs were taken from a donor who was brain dead, with the family’s consent, the statement said.
Experts say the mouth and nose are the most difficult parts of the face to transplant.
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...left out by the AP story, but reported by today's NY Times:
"Dr. Dubernard said his team planned to do another transplant - of bone marrow - on the woman while she was in the hospital in Lyon. Although bone narrow transplants are a standard treatment for some conditions, in this case the hope would be that it would increase the patient's tolerance to a graft."
A *bone marrow* transplant?
"Dr. Lantieri said he had reviewed a summary of the woman's medical record and examined a photograph of her damaged face. The woman's type of injury seemed consistent with proposals to do a partial facial transplant, he said. "She had very strong psychological problems," Dr. Lantieri said. "I said I would not go further if I did not have more examinations by additional psychiatrists to know that she would be able to pursue lifelong immunosuppression therapy." Dr. Lantieri said he believed that Dr. Dubernard "wanted to be first" to do a face transplant, as he had done a hand transplant."
Right. A swell way to deal with concerns about non-adherence to immunosuppression medications in a patient with psychological problems is to obliterate her immune system.
Undoubtably, the improvement in esteem she gains from the transplant will sustain the psychological resources she'll require to deal with the graft versus host disease and nosocomial infections likely in her future, to say nothing of the privledge of being on the receiving end of dozens of passes of a bone marrow needle, myeloablative chemotherapy, days in a room with respiratory and contact isolation, etc...
And what was that for, again? Oh yeah:
"...in this case the hope would be that it [BMT] would increase the patient's tolerance to a graft."
Well, I *hope* so too. But she'll still be taking immunosuppression. Apparently, the "hope" was that in the end she'd have to take less. But immunologically speaking, this is like paying of credit cards with money from a loan shark.
Disgraceful.
- by Some small details.... on Dec 1, 2005 at 9:26 AM | link