Royal Free London face transplantation team: face transplant research
Peter Butler and his colleagues from the Royal Free Hospital face transplant team have been researching the public and patient view on facial surgery and face transplants. They have also been looking at the level of psychological preparation that may be required to select suitable patients for face transplant procedures.
Face transplant research: organ donor focus group views
The UK face transplant team carried out a focus group with five families who had donated the organs of a relative at their death to get their views and opinions on face transplants. Donor families were generally positive about the donation of facial tissue to someone with a severe facial injury, particularly when this reflected the wishes of their relative.
The transplant team at the Royal Free Hospital plans to carry out more research in this area to gain a rigorous view of patient and public attitudes towards face transplants – and see if these match up with ethical issues raised by the Royal College of Surgeons.
Research into the level of psychological preparation needed to select face transplant patients
A major strand of our research has been to understand the level of psychological preparation that is required to ensure the successful selection of patients for face transplant procedures.
The challenge we face is that the people who cope least well with facial injury may also be the people that cope least well with facial transplantation and the long-term impact of changing identity. We therefore need to identify the psychological beliefs and behaviours that produce positive results in other forms of transplantation, such as solid organ (eg heart and kidney) and composite tissue transplantation (transplantation of a combination of skin, nerves, bone, blood vessels, muscle and tendon from another person).
Our research in this area is continuing.
Find out more about changing identity and face transplant ethics in the left hand navigation.
Patient view on face transplants: interactive exhibition
At the 2004 Royal Society Summer Science Exhibition, the team studied 304 visitors to an interactive exhibition about reconstructive surgery and face transplants. Visitors to the exhibit, which was entitled ‘Transplanting Faces’, viewed videos, articles and photographs about face transplants – including examples. Visitors also viewed ‘exchanged’ faces between two of the research team members, generated by computer modelling from photographic and laser scanned images. These images were intended to show how patients could look before and after a full-face transplant.
After viewing the exhibit, participants were asked to complete a short questionnaire that was designed to tackle issues of face transplant ethics, which have been raised by the Royal College of Surgeons. Results showed that the acceptability of face transplants was generally high with over 70% of participants happy to receive or donate a face – even where resemblance to the donor remained high.
But maybe the most interesting finding was that the practical issue of immunosuppression was identified as the major barrier to face transplant operations, rather than philosophical or psychological issues like changing identity.