
Dr. Maria Siemionow of the Cleveland Clinic in Ohio made history this week by successfully performing the first face transplant in the United States. The 58-year old, native of Poland had been preparing the surgery for over a decade. This is only the fourth successful face transplant, following operations in China (2006) and France (2005 and 2007).
Siemionow studied medicine in Poznan, Poland and trained in Belgium, Spain, and Finland before moving to the United States in 1985. She worked in Louisville until 1995, when she went to work at the Cleveland Clinic. Siemionow has done hundreds – possibly thousands – of surgeries throughout her 30-year medical career. Her experience has taught her that results aren't just dependent on the surgeon, but the patient as well.
These experiences have taught Siemionow to be more critical of the patients that she takes on. For this reason, Siemionow spent three years conducting interviews before she selected the patient for her first face transplant. Her requirement was that the person had to be "psychologically stable but not happy", have family support, and commit to taking anti-rejection drugs for the rest of his or her life.
The identity of the transplant recipient is currently unknown, but is expected to be revealed this week. What is known of the patient is that the person was disfigured by a traumatic injury. The operation team, which included Siemionow and seven other doctors, replaced about 80% of the patients face with portions from a donated, female cadaver.
Improving vs. Extending Life Controversy
Face transplants are seen as an ethical controversy because they improve the quality of life, but don't extend it – as with heart and liver transplants. This type of surgery comes with the risk of deadly complications. Patients must take immune-suppression medication for the rest of their lives to avoid rejection of the new tissue.
Advocates of facial transplants have said that the psychological effects of facial damage – whether from injuries, birth defects, or diseases – can be devastating. They believe that the benefits these surgeries would outweigh the drawbacks, as long as the patient and their families understand the risks involved.
Resources:
http://www.news-medical.net/?id=44341
http://health.usnews.com/articles/health/2008/12/17/health-buzz-first-face-transplant-in-us-and-other-health-news.html
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