Facial transplantation: Almost a decade out, surgeons prepare for burgeoning demand

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Plastic and reconstructive surgeons leading the first retrospective study of all known facial transplants worldwide conclude that the procedure is relatively safe, increasingly feasible, and a clear life-changer that can and should be offered to far more carefully selected patients.Reporting in The Lancet online April 27, NYU Langone plastic and reconstructive surgeon and senior author Eduardo Rodriguez, MD, DDS, says results after nearly a decade of experience with what he calls the “Mount Everest” of medical-surgical treatments are “highly encouraging.”The review team noted that the transplants still pose lifelong risks and complications from infection and sometimes toxic immunosuppressive drugs, but also are highly effective at restoring people to fully functioning lives after physically disfiguring and socially debilitating facial injuries.Surgeons base their claims on the experience of 28 people known to have had full or partial face transplants since 2005, when the first such procedure was performed on a woman in France.Of the 22 men and six women whose surgeries were reported, including seven Americans, none have chronically rejected their new organs and tissues, says Dr. Rodriguez, chair of the Department of Plastic Surgery at NYU Langone Medical Center and director of its Institute of Reconstructive Plastic Surgery. All but three recipients are still living. Four have returned to work or school.Dr. Rodriguez, the Helen L. Kimmel Professor of Reconstructive Plastic Surgery at NYU Langone, in 2012 performed what is widely considered the most extensive facial transplant (when he practiced at the University of Maryland Medical Center in Baltimore). The patient was a Virginia man who had lost the lower half of his face in a gunshot accident 10 years earlier. Dr. Rodriguez is currently readying his new team at NYU Langone to perform its first facial transplantation, expected later this year.In The Lancet article, Dr. Rodriguez and his colleagues point out that although all recipients to date have experienced some complications from infection, and mild to moderate signs of rejection, the few deaths among patients were due to infection and cancer not directly related to their transplants. …


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