Transplantation of human face to become real in near future

Such operations are extremely difficult, because skin begins decomposing first in case of death

Rumors have been going around recently, saying that plastic surgeons of this or that country were about to perform the operation to transplant a donor's face. Such a unique operation has not been performed anywhere yet. A group of French medics successfully completed all preparations for operation last year, but the National Ethical Committee banned the initiative. American and British surgeons are still working on the problem, though.

One of Russia's leading specialists in the field of plastic and reconstructive microsurgery, Konstantin Abalmasov, says that transplantation of donor organs, such as heart, kidneys, liver, pancreas, etc, has been successfully practiced in modern medicine for decades already. However, there has not been an occasion registered in medical practice, when specialists could succeed in the transplantation of donor skin taken from a dead person. Doctors may often need a large amount of donor skin in cases of extensive burns, severe injuries received in car accidents and so on.

Only several successful operations have been registered in the world, when doctors transplanted skin along with adjacent tissues. The best operation of the kind was performed in 2001 in the USA, Kentucky: doctors attached two hands taken from a dead donor to a living patient. The outcome of the operation was perfect: the patient uses his new hands without any problems. However, the person has to take medications preventing the graft rejection of foreign tissue.

An international group of 50 medics, including 30 surgeons, performed a similar operation last year in France. The result seemed to be quite successful, but the patient stopped following doctors' recommendations, which resulted in lamentable consequences for the person.

French specialists conceived absolutely new surgery – to transplant a human face from one person to another. This cannot be regarded as plastic surgery of cosmetic character. The operation is meant to help those people, whose face was disfigured or mutilated as a result of states of emergency.

It is noteworthy that such operations are extremely difficult. Human skin is highly aggressive towards any foreign protein and any foreign tissue. The human epithelium carries a large number of most useful functions, which can be easily lost in transplantation. Protecting the body from mechanical impacts and traumas, preventing the penetration of various substances and microorganisms, taking water and metabolic products out of the body are just a few highly important functions, which can therefore be lost after such an operation.

Furthermore, skin starts decomposing first in case of death. It just so happens that surgeons do not have the time reserve, which they have during the transplantation of heart of liver, for instance. To crown it all, skin has an extremely complicated blood circulation system; there are countless nerve endings in skin too. Unlike any other human organ, skin renovates and grows throughout a person's life.

Modern science can offer several alternatives to transplantation of skin: to grow artificial substitutes, to partially produce skin with stem cells, etc. The quality of the received substitute, however, leaves much to be desired – the problem still remains unsolved.

As far as other aspects of the problem are concerned, purely technical questions of such operations are quite surmountable. Plastic surgery possibilities are widely known in the world, when doctors change a person's looks with the help of his or her own skin and bone tissue. It is possible nowadays to recreate the lower jaw from a rib of a patient, for example. Reattaching somebody else's face is quite complicated, albeit real, taking account of the up-to-date development of microsurgery.

Surgeons learned to change the appearance of a human being beyond recognition long time ago, without using risky operations to transplant organs from a dead donor. A lot of Nazi criminals changed their looks decades ago; modern criminals often use plastic surgery as well.

One operation of facial transplantation might cost up to $35,000. About $10,000 more will have to be spent annually for post-operational maintenance. According to experts' estimates, the risk of foreign tissue rejection may reach ten percent during the first year after the operation. However, the risk may drastically increase to 30-50 percent from the second to the fifth post-operational year. 

The price of a heart transplantation operation fluctuates from 50 to 285 thousand USD in the USA. The cost of kidney transplantation varies from $25 to $135 thousand.

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Author`s name Olga Savka