Face Transplants Promised Hope. Patients Were Put Through the Unthinkable (theguardian.com) 18
Twenty years after surgeons in France performed the world's first face transplant, the experimental field that procedure launched is now confronting a troubling record of patient deaths, buried negative data and a healthcare system that leaves recipients financially devastated and medically vulnerable.
About 50 face transplants have been performed globally since Isabelle Dinoire received her partial face graft at University Hospital CHU Amiens-Picardie in November 2005. A 2024 JAMA Surgery study reported five-year graft survival of 85% and 10-year survival of 74%, concluding that the procedure is "an effective reconstructive option for patients with severe facial defects." The study did not track psychological wellbeing, financial outcomes, employment status or quality of life. Roughly 20% of face transplant patients have died from rejection, kidney failure, or heart failure.
The anti-rejection medications that keep transplanted faces alive can destroy kidneys and weaken immune systems to the point where routine infections become life-threatening. In the United States, the Department of Defense has funded most operations, treating them as a frontier for wounded veterans, because private insurers refuse to cover the costs. Patients who survive the surgery often find themselves unable to afford medications, transportation to follow-up appointments or basic caregiving. The field's long-term grants cover surgical innovation but not the lifelong needs of the people who receive these transplants.
About 50 face transplants have been performed globally since Isabelle Dinoire received her partial face graft at University Hospital CHU Amiens-Picardie in November 2005. A 2024 JAMA Surgery study reported five-year graft survival of 85% and 10-year survival of 74%, concluding that the procedure is "an effective reconstructive option for patients with severe facial defects." The study did not track psychological wellbeing, financial outcomes, employment status or quality of life. Roughly 20% of face transplant patients have died from rejection, kidney failure, or heart failure.
The anti-rejection medications that keep transplanted faces alive can destroy kidneys and weaken immune systems to the point where routine infections become life-threatening. In the United States, the Department of Defense has funded most operations, treating them as a frontier for wounded veterans, because private insurers refuse to cover the costs. Patients who survive the surgery often find themselves unable to afford medications, transportation to follow-up appointments or basic caregiving. The field's long-term grants cover surgical innovation but not the lifelong needs of the people who receive these transplants.
Great. Just great. (Score:2)
We've seen how this movie ends, yet they're still pursuing this?
Re: (Score:2)
Are you talking about Dark Man or Face/Off?
Re: (Score:2)
Unthinkable (Score:3, Insightful)
Well all I can say is that I hope I never have to consider undergoing such a procedure. My sympathies to those who suffer as a result. It sounds like it's nothing like they portrayed in the movie Face/Off.
Re: (Score:3)
The people who get them have usually suffered some kind of extremely traumatic injury. IIRC the first woman to have one was mauled by a dog, which literally ate her face.
Before face transplants, the only option was to take skin from elsewhere and use it to repair the face as best as possible, to he point where it looked awful but at better than having no skin. The upside was that because the skin came from their own body, rejection wasn't a big problem.
Face transplants were supposed to offer better function
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Some patients have gotten along well with external organ transplants - one man lost both arms basically at the shoulders due to an electrical mishap - he got 2 arms transplanted on - he is getting on very well with the arms, using them to brush his teeth, pour drinks, and many other things he couldn't do before.
The issue is rejection for the most part - despite the immunosuppressants he was having marks, blemishes etc growing up his arms where his body was destroying them. He might get 10 years out of them
I hate this cliche. (Score:3, Informative)
Not only is it 'thinkable'; having something awful happen when you perform a procedure that requires longterm hardcore immunosuppression and then let them follow through the cracks is trivially predictable. It's the expected behavior. Successfully reconnecting a whole ton of little blood vessels and nerves is fairly exotic medicine; predicting that thing will go poorly without substantial follow-up is trivial even by washout premed standards.
This isn't to say that it isn't ghastly, or that I could imagine being in that position; but 'unthinkable' is closer to being a claim of unpredictability or unknowability; which is wholly unwarranted. None of this was unthinkable; but nobody really cared to check or wanted to know all that much.
Re:I hate this cliche. (Score:5, Interesting)
TFA focuses on what it feels like to live with someone else's face. I believe this part is the unthinkable. It might look logical after the fact, but would have been hard to anticipate. Like touching the inner part of your face with the tongue and finding the feeling "horrible".
Here a very partial selection that illustrates my point:
Isabelle felt less like a princess than a circus animal. After the transplant, she spoke of being tormented: “Everyone would say: Have you seen her? It’s her. It’s her And so I stopped going out completely.”
Living with a stranger’s face was as psychologically difficult as ethicists feared. Two years after the transplant she spoke to the strangeness of having “someone else’s” mouth. “It was odd to touch it with my tongue. It was soft. It was horrible.”
And then one day she found a new hair on her chin – “It was odd. I’d never had one. I thought, ‘It’s me that has given it life, but the hair is hers.’”
after each psychiatric appointment, she would come home “at the lowest, full of guilt and suicidal desires”. More than once, according to her, she attempted suicide after her transplant;
Isabelle never resumed a normal life, never returned to work or good mental health, and from 2013 experienced regular episodes of rejection.
She died in 2016
There are similar story of people who psychologically rejected their new hand after a transplant as "someone else's hand" is too hard of a burden, something they couldn't imagine.
A month ago when I visited a dentist, the anaesthesia was unusually strong and took away sensitivity on half of my face for few hours. Just touching my face was strange and strongly unpleasant despite causing no physical feeling. It felt it wasn't my face. Though I could have "thought" of the effect previously (as everyone I sometimes slept on my arm and woke up with no feelings on a limb) but the feeling of "my face but not my face" is something I hadn't, and possibly couldn't, anticipate.
Other psychological experiences cold be called like that. Grief is among that. You've seen people crying in movies and you believe you "understand". Oh boy, you don't. Even if given time to adapt to the idea that your loved relative is on the one-way slope and has only days or even hours remaining, the anticipation is nowhere close to actual suffering at the very second your relative is truly gone. It is an "unthinkable" experience.
Silence of the lambs (Score:1)
Why are they transplanting? (Score:1)
Re: (Score:2)
That's too much future tech, but for now -- why not install a titanium plate? At least it won't cause rejection issues, and functionality wise is no worse than current transplants. And, instead of on-lookers getting revulsed, you'll get looks of awe. Severely disfigured wetware makes people say they offer compassion, but in reality they're severely disgusted and feel an urge to distance themselves from you -- because biologically, looking ill means something potentially transmissible, which our instincts
Sounds more like a US problem than face-transplant (Score:2)