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medically speaking

Can You Spare an Organ? (…an Organ as in Your Face?)

Does how you feel about giving in every other way, translate to how you feel about organ donation? People donate things every day. Food, money, their time. America as a country, gives the most compared to all others in terms of money towards economic development and welfare. America as comprised of individual citizens, top many world lists and statistics in terms of generous giving in the variety of ways there are to give.

Food for thought: If donations are a gift, why do we receive a tax credit based on how much we give? Why are egg and sperm donors paid?

The first successful organ transplant was in 1954. A kidney between twin brothers. We’ve come a long way since then in body parts going from one person to another. As of the writing of this, 116,901 people are waiting for organs in the United States. From Jan. 2012-Sept 2012 21,132 transplants have been done. (More stats organ transplants click here)

face transplant

face transplant (Photo credit: TheoJunior)

The medical procedure that replaces partial or all of a person’s face is called a face transplant. The first partial transplant was in France in 2005. Isabelle Dinoire’s face had previously been mauled by her dog. A triangle of face tissue from a deceased person’s nose and mouth were grafted on.

The world’s first full transplant was in Spain in 2010. The team of 30 doctors carried it out on a man injured from a shooting accident.

Those disfigured by trauma, burns, and disease may best benefit aesthetically from the procedure. There is a significant difference in that its benefits are not lifesaving in the same context as a transplanted organ is. And it’s caused considerable ethical debate since its debut procedure. An extreme version of plastic surgery perhaps? Some think so.

Jarrahy Reza, a co-surgical director at UCLA pointed out to medgadget.com (in a May 2012 article), “Your appearance and your personality are in some ways inseparable. It’s hard to get past that.” And although face transplants likely will not save anyone’s life, “might enable some people to have a life.”

Your try living with a severely disfigured face…A face that causes people to stop and stare. See how well you handle it.

Alternative options to facial transplants include movement and replacement of skin from the patient’s own back, buttocks or thighs to their face through a series of as many as 50 operations. With the outcome at its best only limited function, an in reality likened to simply a mask.

Medagadget asked Jarrah where he saw transplant surgery going, and he responded, “Face transplantation is interesting in that what we are doing in the operating room is not necessarily new. We have done solid organ transplantation for decades. We do very complex craniofacial surgery at UCLA. We have been a leading center of microsurgery for many years and so the surgical techniques that we are using are not necessarily new by any means. The novelty is combining all of these disciplines into one.”

The world’s first full face replant procedure was successfully preformed on 9 year old Sandeep Kaur in Northern India, in 1994. Her mother witnessed her daughter’s hair being caught accidentally in the thresher machine they used. Her parents brought her face to the hospital in a plastic bag (see image below) and one of India’s top micro-surgeons Abraham Thomas, was able to reconnect the arteries and skin.31943_2_468

In 2004 Sandeep went on to pursue training to become a nurse herself.

A similar operation was performed in 1996 in Australia. These surgeries thus launched the idea that facial transplantation was possibly possible.

L. Scott Levin MD FACS, Chair, Department of Orthopaedic Surgery at University of Pennsylvania School of Medicine, has described transplants as “the single most important area of reconstructive research.” (source here)

Michele R. Berman, M.D. for online blog celebrity diagnosis column explains that a great deal of prep is involved. Recipients are screened physically and psychologically to make sure they will be able to handle the physical and emotional demands that the procedure will entail.

The facial tissues must still be attached to the circulation of a “living” donor who is brain dead with no chance of recovery. Aside from being matched for skin color and skin age, a special test, called a HLA test is performed on the tissue of the donor, the closer the HLA profile of the donor and the recipient, the less likely the tissue is to be rejected.

Check out this brief video by UCLA that explains the process:

http://www.youtube.com/watch?v=XjMz_uq3Tq4

  • In 2004, the United States (Specifically at the Cleveland Clinic in Ohio) became the first to approve this surgery and test it on cadavers.
  • March 2008, 30-year-old Pascal Color of France, sufferer of neurofibromatosis, received world’s first “almost full face transplant.”
  • In December 2008, a team at the Cleveland Clinic, led by Dr Maria Siemionow and including a group of supporting doctors and six plastic surgeons performed the first face transplant in the US on a woman named Connie Culp.
Connie Culp

Connie Culp (Photo credit: Wikipedia)

It was the world’s first near-total facial transplant and the fourth known facial transplant success. This operation was the first facial transplant that included bones, along with muscle, skin, blood vessels, and nerves. The woman received a nose, most of the sinuses around the nose, the upper jaw, and even some teeth from a brain-dead donor. (Source: Wikipedia.)

  • On April 9, 2009 the second US partial face transplant took in Boston on James Maki, 59. He’d been injured in 2005, after falling onto the electrified third rail at a subway station.

The procedure was shown as part of the ABC documentary series Boston Med.

  • July 8 2010, France reported a full face transplant, including tear ducts and eyelids.
  • In March 2011, a surgical team at Brigham and Women’s Hospital in Boston, performed a full face transplant on Dallas Wiens who had suffered severe disfigurement following a power line accident that left him blind and without lips, nose or eyebrows.
  • January 21, 2012, a Turkish medical team full face transplanted19-year-old, Uğur Acar’s face. He’d been burnt in a house fire as a baby. The doctors used the body of 39-year-old Ahmet Kaya, who had died the day before.
  • February 24, 2012, saw the family donated body of a 40 year old, which had been pronounced brain dead following a motorcycle accident Feb. 17; go towards the second for Turkey, successful full face transplant. Recipient 25-year-old Cengiz Gül had lived life since age two badly burned after a television tube implosion.
  • March 17, 2012, marked Turkey’s third partial transplant. Hatice Nergis, a twenty-year old woman, who’d previously, lost six years before, her upper jaw including mouth, lips, palate, teeth and nasal cavity in a firearm accident, received donated facial grafts from a 28-year old woman in Istanbul who committed suicide.
  • On March 19, 2012, the 23rd facial transplant ever to occur; from the hairline to the neck, was performed on Richard Lee Norris of Hillsville, Virginia, in Baltimore, Maryland, to repair the trauma of a gunshot wound in 1997. (see image at left)Richard-Lee-Norris
  • In March 2012, a face transplant was completed in Maryland on a 37 year old man who had a facial ballistic injury from 1997. This transplant represents the most extensive to date, and included all facial and anterior neck skin, both jaws, and the tongue.

This isn’t Face/Off, in real life after the procedure, the patients tend to look a bit like a combination of themselves and the donor. Images of Richard Lee Norris, Dallas Wiens, Carla Nash, Mitch Hunter,Li Guoxing, Isabelle Dinoire, Connie Culp before and after can be found at CBSNewsImages

To read more of a first-hand account of what it was like going through the procedure, I recommend reading this 2005 piece from the Pittsburgh Post-Gazette about David McDowell.

Since 2005, 19 patients have had full or partial facial transplants. Only two patients have died. This remains an emerging field that physicians around the world are continuing to monitor.

Glimpse into China’s efforts. (2008 video)

This past September 2012, the 47th Annual Meeting of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), met in Washington D.C.

Guests included Bernard Deveachelle, MD, who performed the first face transplant in the world, and J.P. Meningaud, MD, who has performed five procedures, as well as actual patients of the facial transplant surgery. The Academy’s mission was to ensure members undergo extensive training and competence, embody high ethical standards and artistic ideals to enhance the quality of human life.

The AAFPRS is the world’s largest specialty association for facial plastic surgery. It represents more than 2,700 facial plastic and reconstructive surgeons throughout the world. The AAFPRS is a National Medical Specialty Society of the American Medical Association (AMA), and holds an official seat in both the AMA House of Delegates and the American College of Surgeons board of governors.

For more info see the AAFPRS website.

UCLA launches first face transplantation program in western U.S. 2012!!

“The UCLA Health System has launched a face transplantation program for patients with devastating facial trauma, burns, or birth defects. It is the first such program in the western United States. The organizers of the program are currently looking to recruit potential patients with severe facial disfigurement who would be interested in enrolling as five-year study volunteers. Potential patients can come from anywhere in the United States.”

I’ve personally been fascinated with all things organ donated related for some time now. When I learned I IMAG1359-1-1could be a skin donor, I was like, sign me up I won’t need that skin after I die. It’s just doing to rot (#thatsmorbidhuh?) I’m an EVERYTHING donor. What inspired me write this article was a post I saw online that a friend several states away has more than once posted on his Facebook. A fundraising page for a girl named Sarah.

“Sarah was in a tragic ATV accident on October 16, 2012. When she was going downhill she lost control and flipped. Unfortunately she wasn’t wearing a helmet and the ATV landed on her face causing extensive injuries and required her to be life flighted to Grant Medical in Columbus, OH. All the bones in her face from the eye sockets down have been shattered into many pieces. The doctors aren’t sure what all is fixable at this point and feel the only option for reconstruction would be a total facial transplant…”

The page (here) was created by her friend Jasmine Wood on October 19, 2012, in the efforts of raising money to pay for the bills for her extensive treatment as she appears to be possibly be wait listed for the procedure.

I hope you’ll check out her page and consider pitching in. They’ve raised a little under $4000 towards their $50,000 efforts.

Are you can organ donor?

For more information see the below links

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About maggie.

Maggie Barnes is a nonprofit and for profit business content specialist / social media consultant; and social sciences web writer interested in everything from psychology and sexuality, to technology, race, and economics. She is passionate about good communication and information accessibility.

Discussion

2 thoughts on “Can You Spare an Organ? (…an Organ as in Your Face?)

  1. Oh my goodness! Impressive article dude! Many thanks,
    However I am having difficulties with your RSS. I don’t know the reason why I cannot subscribe to it. Is there anyone else getting the same RSS issues? Anyone that knows the solution will you kindly respond? Thanks!!

    Posted by Cathryn | April 10, 2013, 7:26 pm
    • Hi! Thanks! I’m not sure what’s up with the rss feed, but regardless I no longer update this site. I’ve moved to http://www.interesting12.com (I’ve dropped the .wordpress.com)I hope you’ll come check me out over there! All my old content and everything new can be found there 🙂 Thanks again!

      Posted by maggie. | April 10, 2013, 9:22 pm

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