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On November
27, 2005, 38-year-old Isabelle Dinoire was the first person to ever undergo a
face transplant intervention, after being severely attacked by her dog. The
consequences of the attack were the amputation of her distal nose, her upper
and lower lips, the entire chin and parts of her right and left cheeks. The donor
was a brain-dead 46-year-old woman with the same blood group (O+) and five
compatible HLA antigens.
The
intervention was not only controversial and risky, but also required multiple approvals
from the Local Protection of Persons Committee, the French Agency for Health
Safety and the French Biomedicine Agency. The surgeon responsible for the face
transplant was Jean-Michel Dubernard, who admitted that not only was the
intervention a difficult one, but the recovery process was even more
complicated.
According to
a report published in The New England Journal of Medicine, the patient was able
to drink and eat within the first week after the surgery, although the leakage
from her mouth completely disappeared only 12 months later. Heat and cold
sensations were close to normal 4 months after the intervention.
The same
report also mentions that the sensory recovery was much faster then the motor
one, as the patient was able to move her upper lip only 4 months after the
transplant. The smile was still incomplete after 4 months, and remained asymmetric
for the first 10 months, becoming normal only 2.5 years after.
The post-operatory
recovery was the part specialists feared the most, more than the intervention
itself. One of the first bad signs was the experimental infusion of bone marrow
stem cells from the patient’s donor. The immune system did not tolerate the
graft, so the doctors had to use immune-suppressing drugs, which Dinoire will
have to take for the rest of her life.
Despite the
immune-suppressing treatment, the body’s natural rejection response appeared 18
days after the operation, and also six months later. For the time being, the
patient receives an experimental treatment that doctors hope will prevent
future rejections.
Isabelle
Dinoire is happy with her new face despite the complications, and says she is
not afraid to walk or meet anyone. "Everyone in the world said this should
not be done because the world was not ready and the risks were too high," said
Dr. David M. Young, assistant professor of plastic surgery at UC San Francisco.
“The French medical team has beaten the odds."
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