Face transplant patient nearly lost new features
TUCSON, Ariz. – French doctors treating the world’s first face transplant patient say she suffered a tissue-rejection episode that threatened to cost her her new features, but she is doing well now – so well that the surgeons hope to do five more such operations soon.
“She can swallow and eat. That was impossible before the surgery. Psychologically, she’s very happy,” said Dr. Jean-Michel Dubernard, a surgeon from Lyon, France.
“For us, this experience is the best proof that we are right” to have done the transplant instead of trying routine reconstructive surgery, Dubernard said, referring to criticism of the operation.
However, his revelation of the rejection episode illustrates a danger the woman will live with the rest of her life, and the extraordinary risks in face transplants, which several U.S. surgeons also hope to offer soon.
The 38-year-old French woman received a new nose, chin and lips from a brain-dead donor on Nov. 27. She was severely disfigured last spring when her pet Labrador bit and scratched at her face while trying to wake her.
Dubernard spoke in an interview before the start of a transplant surgery conference in Tucson where he was to make the first scientific presentation on the operation. He brought dramatic photos, which he would not make public, showing the horrific injuries suffered by the woman, who one doctor said referred to herself as “a skeleton, a dead head.”
The lower two-thirds of her nose had been ripped away. Both lips were gone, leaving her teeth bared in a grotesque grimace. The holes where nostrils once were gaped open and ghastly.
Doctors did a series of computer animations to simulate the best they thought they could do for her with routine plastic surgery, but the results appeared so dismal they decided to attempt the transplant.
About three weeks after the operation, doctors noticed the transplanted skin turning red and suspected that she had an infection. But a biopsy showed the true culprit: her immune system actually was attacking and rejecting the new face.
They tried to treat this by increasing the dose of the steroid prednisone, an immune-suppressing drug. They even gave her a face cream and mouthwash containing the medication, but they didn’t help.
On Dec. 30, doctors resorted to giving her huge doses of the steroid drug, and finally succeeded in halting the rejection episode on Jan. 2.
“She was alarmed” at the prospect of losing her new face, but was relieved when it looked normal again after a few days, said Dr. Emmanuel Morelon, another of her physicians.