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Doctors Describe First U.S. Face Transplant
Date:12/17/2008

xisting, conventional procedures, a condition for eligibility for the rare procedure.

Although this is the first such procedure in the U.S., 38-year-old Isabelle Dinoire successfully underwent a partial-face transplant in France in 2005, after being mauled by her dog. Since then, two other face grafts have been performed, one in China in 2006 and another in Europe in 2007.

At the Wednesday press conference, Cleveland Clinic bioethicist Dr. Eric Kodish stressed that the patient, considered to be a participant in human subjects research, was "appropriately protected."

"We believe the ethical basis for this endeavor is beyond reproach," he said. "We can anticipate that some may be concerned that this will be used as a means of identity transfer or as a cosmetic technique. We will do the best to prevent this from happening and we believe society can reach consensus and put safeguards in place to prevent that. This must be limited to the medical context, and we do not think this should be used for cosmetic enhancement."

"This is not cosmetic surgery in any conventional sense," he continued. "The face is the physical embodiment of a person's identity, and human beings are inherently social creatures. A person who has sustained a trauma or other devastation to the face is generally isolated and suffers tremendously. The damage to quality of life cannot even be put into words."

The Clinic's Institutional Review Board approved the surgery in late 2004.

The sequence of events leading to the face transplant began in the middle of the night several weeks ago when Francis Papay, chairman of the clinic's dermatology and plastic surgery institute, received an phone call telling of a potential donor.

Other members of the already assembled surgical team were immediately contacted through a sort of "phone tree," then waited throughout the night to confirm the donor was a match.

Surgery began at 5:
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