Texan Waits for Rare Face Transplant Surgery

December 18, 2010

A Texas man who lost his entire face in an electrical accident is waiting for a suitable donor - and to realize his wish to feel his daughter's kisses again. The man, Dallas Wiens, awaits a rare face transplant, and his experience demonstrates the achievements that have been made in the treatment and rehabilitation of catastrophic injuries like severe burns.

The Electrical Accident

Wiens was critically injured while painting a church on a boom lift in Texas. His brother, who was also working at the church, told Wiens that he appeared to have lost control of the lift and drove straight into nearby electrical power lines. When Wiens' head made contact with a high-voltage power line, the electrical current burned off his facial skin and most of his facial features, including his upper lip, teeth, nose, left eye and eyebrows.

Wiens was rushed to the burn unit of Parkland Memorial Hospital, where he was in a coma for three months. In a 32-hour surgery, skin from his back and thighs was grafted onto his face, covering it from forehead to chin and ear to ear. There are slight indentations where his eyes and nose once were and an opening for his mouth. Even though his lips, teeth and eyes are gone, he can speak clearly and ambulate with a walking stick.

Awaiting Face Transplant Surgery

Following more than 20 operations and dozens of physical and psychological tests, Wiens has been cleared by doctors to be just the third American patient to receive a face transplant. Once he is notified that a donor has been found, Wiens will go to Brigham and Women's Hospital in Boston, Massachusetts, where he will have the surgery and remain hospitalized for at least six weeks afterward.

The U.S. Department of Defense will underwrite the cost of the surgery, which is about $300,000, in its effort to eventually help soldiers with severe facial injuries. Weins' health insurance will cover the cost of anti-rejection medicine and other treatment needs after his surgery.

A New Frontier: Face and Hand Transplantation

Face transplantation is a new and rare field of medicine. Since 2005, only 11 face transplants have been performed worldwide, according to The Dallas Morning News. Brigham and Women's Hospital and The Cleveland Clinic in Ohio are the only hospitals in the U.S. thus far that have performed the complex surgery.

Face and hand transplants can drastically improve the quality of life for people who have experienced severe injury or disease. When conventional facial-reconstruction methods like plastic surgery are not feasible, face transplant surgery can provide functional and aesthetic benefits that can allow a person to breathe through the nose and feel more comfortable in society.

However, face transplants generally are classified as nonessential operations because, unlike organ transplants, most people can survive without them and they carry significant inherent risks.

Multiple-Tissue Transfers

Face transplants and other multiple-tissue transfers like hand transplants are called composite tissue allotransplantation (CTA). These transplants are particularly complex because they involve several different types of tissue, including:
- Skin
- Muscle
- Tendon
- Bone
- Cartilage
- Fat
- Nerves
- Blood vessels

Another challenge in face or hand transplantation is the difficulty of finding a suitable donor. Not only must the donor meet the criteria for other organ transplantation, such as matching blood type -- CTA surgeons also wish to match the donor's skin color and texture, gender and ethnicity to that of the recipient.

To avoid rejection of the transplant, people who receive face or hand transplants must take immunosuppressive medication for the rest of their lives. Also, recipients must make frequent return visits to the hospital for monitoring and testing.

Even with proper medication and careful observation, it is possible that the recipient's body will reject the transplant or that serious complications will result from taking immunosuppressive drugs for a lifetime. In addition, it can take years of physical therapy and rehabilitative training for the transplanted face or hands to gain function and feeling.

Advancements in face and hand transplantation have expanded the possibilities for people who have suffered serious injury or amputation. While these procedures are new and rare, they may become more common as the number of successful multi-tissue transplants increases and as advances are made in this cutting-edge field of medicine.

Article provided by Scott H. Palmer, P.C.
Visit us at www.scottpalmerpilawyer.com