Pocket Doc
Issue date: 7/14/08 Section: Pulse
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Q: What is the current status of face transplants?
A: Great question since we are at one of the premier organ transplant centers of the world. Our Dr. Enrico Benedetti leads a Transplant Service that is especially active in transplanting kidneys and livers as well as pioneering small intestine and Islet Cell (pancreatic cells responsible for producing insulin) transplants.
The whole Halloween mask/face transplant thing is more than a little reminiscent of the very scary movie "Face Off" with John Travolta and Nicholas Cage.
Face transplants have been studied in France, the UK, at Louisville and The Cleveland Clinic here at home. This surgery is a big deal, and not done because someone feels that they would be "more fulfilled" if they looked like Leonardo DiCaprio or J-Lo. Candidates will be people who have suffered devastating facial burns, oral-maxillary cancers (chaw of tobacco anyone?), birth defects, or trauma from things like disfiguring dog bites. This isn't just a cosmetic thing, either. In many cases these poor people can't eat, see, smell, hear, or interact with others without scaring children. Can you imagine how lonely that would be? Not to mention a whole loss of the identity that we associate with seeing our own face in the mirror.
The perils, psychological and physical, are also enormous. Skin is one of the tissues (actually called an organ in its entirety) causing a vigorous immune response, so candidates would need to be on potent immunosuppressive medication for life. Kidney damage, an enhanced susceptibility to infection, and amplified cancer incidence are just some of the risks associated with those poisons. And you don't even want to contemplate the situation if the transplanted tissue is rejected. A bad face could become a much worse face if that happens. With no barrier from the outside world, overwhelming infection and subsequent death would likely result.
One of the issues that is also a new frontier is the reaction of donor families to the patient, at least partially, taking on the appearance of a deceased loved one. Actually, this is likely more a psychological risk than a real one since it is the bones and underlying muscle tissue that will determine appearance, not the transplanted skin from the donor. Still, one might feel like they had put on a mask of another's face. Identity problems never before anticipated could result.
No plans for moving on such technology here in the near future. We have to leave some of the medical advances for the rest of the world...
Dr. George is an Emergency Room physicians with the University of Illinois at Chicago's Medical Center.
As with all medical advice, consult your physician before beginning any regimen or if symptoms persist for more than five days.
Send your anonymous questions to pulse@chicagoflame.com
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