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French Doctors Perform First Partial Face Transplant

ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MELISSA BLOCK, host:

And I'm Melissa Block.

There are new details today about the world's first partial face transplant. In Lyon, France, the team that performed the operation spoke to the press. Frank Browning was there.

Unidentified Man #1: (French spoken)

Unidentified Man #2: (French spoken)

FRANK BROWNING reporting:

The slightly shabby basement auditorium of Lyon Civic Hospital was packed with reporters from all over the world. Dr. Jean-Michel Dubernard presented the first concrete news about the operation conducted last Sunday in the northern French town of Amiens.

Dr. JEAN-MICHEL DUBERNARD: (French spoken)

BROWNING: `She's eating, she's talking and she's drinking without any problem today,' which, Dubernard explained, are things she could not do a week ago. The patient, whose name is being withheld to protect her privacy, is a 38-year-old woman. One night last spring, unable to sleep, she got up to take a sedative and her dog attacked her, ripping off her nose, both lips and most of her chin.

Dr. DUBERNARD: Given time, in a lip, it's very difficult to drink, for example, OK? So now she has some passive protection, OK? But the problem was before the transplantation, she was like that, without possibility of opening the mouth.

BROWNING: Dubernard and the other doctors explained that they could not use traditional plastic surgery, in part because lip tissue has no counterpart elsewhere in the body that could be used to reconstruct her mouth. Thus, the key was to find a compatible donor, a donor whose identity by French law the doctors may not reveal. Another critical element was to be sure the donor's skin color and surface quality matched. Even more important was finding a close enough immunological match to keep the recipient's body from rejecting the new face, explained Bernard Devauchelle, who is a specialist in facial surgery.

Dr. BERNARD DEVAUCHELLE (Specialist in Facial Surgery): (Through Translator) I would say we have a very good chance of avoiding rejection. There are six degrees of compatibility, and here we have five of the six, so it's something very positive.

BROWNING: Among the key challenges were joining tiny nerve fibers and blood vessels that honeycomb the muscles and skin of the face, providing color and enabling a person to show normal expressions of fear, pleasure and surprise. Devauchelle said the team realized they had passed the first hurdle when, after four hours, the transplanted skin began to show a rosy glow. However, there remain high risks of rejection. The woman will have to take anti-rejection or immune suppression drugs for years, if not forever, and that could subject her to high risks of disease and even cancer, which provokes tough ethical issues, said Carine Cambi(ph) of the National Medical Ethics Board.

Ms. CARINE CAMBI (National Medical Ethics Board): (Through Translator) The first thing was that she understood that the explanations given her by the medical team were as precise as possible but that, even so, there remained a number of unpredictable problems that could arise.

BROWNING: Two hospital psychiatrists and one outside independent psychiatrist interviewed the woman over the six months she waited a surgery before giving their go-ahead. But for lead surgeon Jean-Michel Dubernard, who's also a member of Parliament and who pioneered full hand transplants, the decision was clear the first time he saw the patient.

Dr. DUBERNARD: My philosophy and our philosophy is very simple. We are doctors. We have a patient with a very severe disfigurement. So as doctors, if we have the possibility to improve our patient, that's what we can do.

BROWNING: On Monday, the woman saw her new face for the first time and, according to Dubernard, her response was immediate: `Merci beaucoup.' For NPR News, this is Frank Browning. Transcript provided by NPR, Copyright NPR.

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