Face transplant

Key Points

National report - Brigham and Women's Hospital in Boston has joined the short list of the world's hospitals that have permission to offer full or partial face transplants.

The hospital has given a surgical team led by Bohdan Pomahac, M.D., the OK to perform partial transplants, according to published accounts.

Meanwhile, surgeons who performed the world's first and third partial face transplants are planning future procedures, and their current patients continue to progress well, the physicians tell Dermatology Times. A surgeon in China did not respond to questions about the status of the world's second transplant recipient.

The Boston project will be unique because, out of concern for risks created by the immunosuppressive drug regimen that face transplant recipients require, Dr. Pomahac plans to limit the procedures to patients already taking immunosuppressive drugs, according to The Boston Globe.

Patients whose facial disfigurement makes them candidates for face transplants are few, he says. Factor in the requirement that they also be on immunosuppression - meaning, most likely, that they are organ transplant recipients - and the pool grows even smaller, he says.

Published accounts say that in the next several months, Dr. Pomahac, who had not returned calls for comment at press time, will meet with Massachusetts doctors who may have appropriate patients.

Brigham and Women's Hospital will require extensive medical and psychiatric screening of potential recipients. Doctors also have met with the New England Organ Bank, which is creating a special consent form and process for potential donors' families, according to The Boston Globe.

The new consent form and procedure are "a good and necessary idea. Getting donors will pose a major hurdle, and this could help," Dr. Barker says.

Cleveland continues search

Meanwhile, a Cleveland Clinic team led by Maria Siemionow, M.D., says it has 15 potential patients waiting for full face transplants, according to one published account. The clinic would not confirm this, however.

"We have a number of candidates who have gone through the screening process, but (we) continue to screen potential candidates," clinic spokeswoman Angie Kiska tells Dermatology Times.

French move forward

Elsewhere, a team based at Henri Mondor Hospital, Creteil, France, will start a waiting list in September to begin fulfilling that program's goal of completing five facial transplants over three years, according to Laurent Lantieri, M.D., head of plastic surgery and team leader.

Part of the protocol involves waiting at least six months after the team's first transplant, performed on a man with neurofibromatosis, to assess results, he notes. (See "French neurofibroma patient,".)

"At the end of the five transplants, we will have the data to see if we should go further, and if this should go into clinical practice," Dr. Lantieri says.