Wed, Nov 19, 2003 page2

• Face transplants nearing reality

  FACE/OFF Experiments conducted on rats are paving the way for more complicated reconstructive surgery on humans, but are also raising a series of ethical questions

  • By Joy Su / STAFF REPORTER
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  Breakthrough facial and scalp transplants in rats will serve as a model for future plastic and reconstructive surgery on humans, doctors at the Chang Gung Memorial Hospital announced yesterday afternoon.

  "Recent experiments have proven that facial transplants such as those seen in popular movies are now possible in rats," said Wei Fu-chan (魏福全), director of the hospital.

  The experiments, which were conducted last year, involved taking the facial skin and scalp from black rats and transplanting the tissue on white rats. Of the 25 rats that received new faces, four were declared a success, with the rat living longer that 400 days after the operation and showing no signs of infection.

  

  This undated photo shows two mice who underwent facial transplant surgery at the Chang Gung Memorial Hospital in Taipei.

  PHOTO COURTESY OF CHANG GUNG MEMORIAL HOSPITAL

  "[In the unsuccessful cases,] the rats died because they were too small to endure the six-hour procedure," said Betul Ulusal, the surgeon who performed the operations and a member of the hospital's plastic and reconstructive surgery team.

  "Facial transplants ... require the lifting of more than one tissue type. They require the transplantation of the skin, the scalp, blood vessels and other tissues, depending on the situation," Wei said.

  According to Jimmy Huang (黃維超) of the hospital's plastic and reconstructive department, researchers in Taiwan have previously only been able to perform thigh transplants on dogs and rats.

  "Facial transplants are harder to perform than thigh transplants, because of the rejection of donor tissue. Future research will need to focus on immunosuppressive therapies," Wei said, explaining that rejection was a difficult problem in dealing with skin trans-plants in particular.

  "Ulusal was able to isolate the four key blood vessels that have to be connected in order to sustain vitality. This is crucial, as it cuts down on the time needed for the surgery," Wei said.

  According to Wei, the Chang Gung team would be able to learn the technique in about three months. He said their next step would be to apply the research to pigs, given the genetic similarities between pigs and humans. In humans, arm transplants would be the next step.

  However, Wei warned about the ethical aspects of facial transplants.

  "The societal and ethical impacts of facial transplants on human beings will be even more complex than the surgery itself," Wei said.

  "One problem will be psychological. Looking in the mirror and seeing a different face will no doubt have an impact on a person's psychological health. Also, a face transplant will affect society's crime management if criminals are able to obtain a new face. Because research is still in its early stages, laws restricting research in this area have not yet been established," Wei said.

  However, Ulusal said that several patients who had sustained facial injuries told her that they would rather die than live with their facial distortions.

  "The experiments serve as a model for future research into full functional and aesthetic reconstruction," said Ulusal.

  Rather than being used to reconstruct a patient's own face, the surgery will replace the patient's face with a different one, she said.

  Wei also said that facial donors would be rare.

  "Research will run into many problems, but as a doctor it is my responsibility to introduce new medical possibilities right now. The torch will be passed on to future doctors," Wei said.
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