According to a recent review in Plastic and Reconstructive Surgery, face transplants, once on the fringe of medicine, may eventually become more mainstream because of new estimates that suggest the risk of tissue rejection might be lower than previously thought.
“We can only know the true immunological risks associated with face transplants by carefully observing those who have already had the procedure,” said ASPS President Roxanne Guy, MD. “While this paper doesn’t provide conclusive evidence of the immunological risks, it will help us move forward in making face transplants part of mainstream medicine.”
Currently, immunosuppressive drugs are the biggest barrier the medical community faces in performing any transplant because the potential long-term side effects of these medications can make the risk too great.
The authors suggest previous immunological risk projections are inaccurate because they were based on immunosuppression drug regimes that are different than the regimes that will be required of face transplant patients.
When using an immunosuppressive drug regimen consistent with face transplant recipient requirements, the authors believe patients would have a relatively low risk of chronic or continual rejection after surgery—less than 10%. In addition, advances in immunosuppression therapies have increased the capacity to manage face transplant patients and potentially reduce acute or immediate rejection episodes.
The authors also suggest that the immunological risks are lower because face transplant patients may on average be healthier and less likely to suffer from extenuating health issues. Organ transplant recipients, on the other hand, often are extremely sick and have numerous, pre-existing health conditions that make them more susceptible to the complications related to immunosuppressive treatment. For example, kidney transplant recipients commonly have hypertension, diabetes, anemia, or bone disease. Face transplant recipients; however, may not be hindered by additional health concerns, lowering their risk.
Additionally, the human hand is comprised of similar tissue as the face. This has led plastic surgeons to hypothesize that face transplant patients would carry similar low risk of acute rejection as hand transplant recipients.
[ASPS, October 10, 2007]
