Researchers say the idea of a face transplant is becoming increasingly feasible.
New faces constructed for a Chinese man after a bear attack and a French-Caribbean man disfigured by a rare tumour show that such transplants can work. The latest cases give hope to those suffering from severe facial deformities, researchers reported in an issue of The Lancet medical journal that will be published Friday.
The separate research teams from France and China reported on the status of their patients in the journal. France performed the surgery one year ago and China two years ago.
Techniques were surprisingly effective, though complications exist and more work is still needed, doctors said.
"There is no reason to think these face transplants would not be as common as kidney or liver transplants one day," Dr. Laurent Lantieri, one of the French doctors who operated on the man with the tumour, told The Associated Press.
Last year the French team worked on a 29-year-old man who suffered from von Recklinhausen disease, an illness that causes facial deformity.
They transplanted a new lower face from a donor, giving the patient new cheeks, a nose and mouth. Six months later, he could smile and blink.
Researchers believe that the case shows that removing a large part of the face and replacing it with donor tissue is possible.
"Our case confirms that face transplantation is surgically feasible and effective for the correction of specific disfigurement," wrote Lantieri and colleagues at the Henri-Mondor hospital outside Paris.
The face of 30-year-old Li Guoxing from a remote village of Yunnan province in China was severely damaged when he was mauled by a bear in October 2004. The wound was originally repaired with a flap from the left forearm, but the facial wounds did not heal properly. He then sought out Xijing Hospital in 2006.
"The major injury was extensive," researchers wrote in The Lancet.
The surgery included connection of arteries and veins, repair of the nose, lip, and sinuses, as well as other structures in the damaged part of the face, a press release stated. After a few months, he could eat, drink and talk normally,
"This case suggests facial transplantation might be an option for restoring a severely disfigured face, and could enable patients to readily integrate themselves back into society," wrote Xijing hospital professor Shuzhong Guo and colleagues.
In both face transplants, the patients started rejecting the transplanted tissue more than once and continue to take medication to counteract the problem.
Some experts worry that taking lifelong anti-rejection drugs after a transplant could increase a patient's risk of getting cancer and that re-growing tissue from the patient's stem cells is the best option. Others also predicted that rejection would destroy the face within a few years, which so far has not been the case with the first three transplants.
A French woman, Isabelle Dinoire, received the world's first face transplant in 2005 after she was disfigured by a dog attack.
The operation not only restored her appearance, but also her self-confidence, so that she was willing to go out in public again, doctors reported in 2006.
Although doctors plan to do more face transplants, the biggest obstacle could be the lack of donors.
"Everyone says they would accept a face transplant if they were disfigured," Lantieri told The Associated Press. "The real question is, would you be a donor, or would you allow your family member to donate their face? That is the answer we need to change."
With files from The Associated Press
