Last Dec. 9, eight surgeons from the Cleveland Clinic replaced 80 percent of Culp's face and jaw during a 22-hour operation. The donor was a woman who had been pronounced brain dead and was a match for Culp's age, race and skin complexion. The new face included the nose, upper lip, lower eyelids, upper jaw, incisor teeth, palate and various glands, as well as bones and ligaments. Culp, then 46, was given immunosuppressant drugs to prevent rejection.
Before operating, surgeons weren't sure if all of the donor tissue could be supplied with blood through the facial arteries, but bleeding from the tissue during the surgery told them the facial arterial system would be enough, according to the report.
"It demonstrates not only a masterpiece of surgical technique but the importance of modern medical teamwork to accomplish this patient's goals," Larrabee said. "Technically, the ability to use just the facial blood vessels and not the deeper ones opens new possibilities. Eventually this operation could become standard for severe facial injuries."
Dr. Laurie Casas, a clinical associate professor of surgery at the University of Chicago Pritzker School of Medicine, said much more needs to be learned before facial transplants become anything more than experimental. Some of the key questions that need to be answered are the long-term impact on patients, including to what extent they are able to return to normal activities, such as work and socializing.
"We are all so excited about the fact that it can be done. The question is, 'On whom should it be done? And when should it be done'?" Casas said. "The world, including the United States, is just beginning to understand how face transplants will really fit into our reconstructive efforts."
Culp will likely have another surgery later this year to remove extra glandular tissue around
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