‘Most complex’ facial transfer so far

TWO teams of highly skilled staff are generally needed to ensure a face transplant runs smoothly.

The first team works on retrieving the face from the dead donor in a procedure lasting between two and four hours.

Veins, arteries, skin and subcutaneous fat are taken from the face alongside muscles leading to the lips, cheek and forehead.

Ears, bones and hair are also cut from the body if they are required for the transplant.

Half-way through, and only once the retrieval team is sure there will be no problems removing the donor’s face, the patient who will receive the face is prepared for surgery.

They are anaesthetised and any previous skin grafts may be taken off.

The donor face, once fully removed, is generally wrapped in saline-soaked swabs and put on ice to be transported to the patient.

The major part of the surgery then begins, involving the retrieval team and the transplant team.

The donor face and any required vessels are attached to the patient during complex microvascular surgery.

The patient will have been matched as closely as possible with the donor for skin tone and hair colour.

The hope is that the patient’s body will not immediately reject the face and that blood flow can be established so the face turns “pink”.

By the start of the operation, psychologists have done most of their work but they are on hand to support the donor team as well as the surgeons.

In the Spanish face transplant first, more than 30 medics carried out the operation at Barcelona’s Vall d’Hebron University Hospital on a young man who was injured in an accident five years ago.

The patient was unable to breathe, swallow or speak properly before the transplant and was dependent on artificial equipment to breathe and eat.

He received new facial muscles, skin, nose, lips, jaw, teeth, palate and cheekbones in the 24-hour operation, which was performed on March 20.

In the first part of the operation, the soft parts of the face, including veins and arteries, were extracted before firmer tissue was removed.

The young man’s arteries and veins were then isolated and the donor’s face checked to ensure there was a complete flow of blood.

Bones and connecting nerves are then transplanted to the new face.

Professor Peter Butler, who hopes to carry out a full face transplant in Britain shortly, said: “It’s a technically challenging operation.”

His team is understood to still be looking for donors that provide an exact match for several British patients.

Prof Butler said: “We congratulate Dr Joan Pere Barret and his transplantation team in Spain on what may well be the most complex facial transplantation operation carried out so far worldwide.

“Secondly I would like to wish the patient well for the future.

“We must also remember the family of the donor who, we understand, has helped not only the facial transplantation patient, but others, with various forms of organ donation.

“To help others, not only to live but to have a good life, is a supreme act of human generosity.”

The most severely facially injured people “live a terrible twilight life, mostly shut away and hiding from public gaze”.