THE world’s first full-face transplant could be conducted in Britain within months after surgeons were given the go-ahead yesterday to start selecting patients.
Peter Butler, of the Royal Free Hospital, in London, was cleared by its ethics committee to evaluate candidates for the operation, to determine whether they are physically and psychologically suitable.
When an appropriate patient comes forward, he or she could become the first in the world to receive an entire new face. Though a French team conducted the first partial face transplant last month, Mr Butler’s team is proposing to perform a full graft from neck to scalp.
“This is a critical step forward that moves us a lot closer to our ultimate goal,” the consultant plastic surgeon said yesterday. “What we can do now is to look for patients and put them through the psychiatric, psychological and surgical assessments we have devised to ensure we get the right candidate. It is very important that we choose wisely. If we do not get it right it would be a disaster not just for the patient but for the whole field.”
The Royal Free team has already been approached by about 20 patients interested in having a transplant, most of them burns victims, but has not yet been able to consider any of them for treatment because the hospital had not given ethical clearance.
Mr Butler now expects many to get back in touch to be formally assessed, though he will not contact any of them himself to guard against charges of coercion.
Good candidates would have to have extensive injuries such as pan-facial burns and must be psychologically capable of coping with a new facial identity.
Mr Butler has spent the past four years compiling an array of evaluation tests and has now been given permission to use them with real patients.
If an appropriate patient is found, a transplant could take place within a year, though Mr Butler will first have to apply to the Royal Free’s ethics committee for permission.
Its decision is likely to be controversial, because the Royal College of Surgeons has not changed its position since advising in 2003 that it is too soon to attempt the procedure.
Mr Butler, however, said yesterday that much of his recent work has addressed the Royal College’s concerns about the likely psychological impact of the operation. Many sceptical surgeons, he said, have also changed their views since the success of the French transplant, conducted on Isabelle Dinoire, who lost part of her face when she was attacked by her dog. “The French operation has shown that this is technically possible,” he said.
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