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The donor face of the recipient of the face transplant fails now



A woman badly burned in a domestic violence attack in Vermont hopes for a second facial graft after doctors recently discovered tissue damage likely to result in loss of her donor's face.

Carmen Blandin Tarleton, 51, In 2007, she burned over 80% of her body when her estranged husband poured lye on her body after beating her with a baseball bat. Six years ago, she received a facial graft at Brigham and Women's Hospital in Boston, where she is being examined for a possible second transplant.

Tarleton, who now lives in Manchester, NH, told the Boston Globe she has no regrets about transplanting because it dramatically improves her life. She has learned piano and banjo, written a memoir and talked to many groups about her life. She lost 20 pounds and started walking five miles a week.

"Before my facial transplant, I had such a low quality of life. Do I wish it would have been 1

0 or 20 years? Of course, "she said.

Worldwide, more than 40 patients received a facial transplant, 15 of them in the United States. None of the American patients has lost his donor face, but last year a Frenchman whose immune system had rejected his donor face eight years after his first transplant had a second one. However, her situation is a reminder that face transplantation, despite its achievements in this field, is experimental and still a young science with many unanswered questions about benefits versus long-term risks.

"We know so many unknowns and discover so many new things," Dr. Bohdan Pomahac, Plastic Surgery Director at Brigham and Women & # 39; s and one of Tarleton's surgeons. Still, he said, "It's really not realistic to hope that faces will last a lifetime (for the patient)."

Dr. Brian Gastman, a transplant surgeon at the Cleveland Clinic, who performed the first facial transplant in the US 11 years ago, said more and more patients are suffering from chronic rejection. "We all believe that every patient will probably need another transplant," he said.

Since her February 2013 transplant, Tarleton had recurrent rejection episodes as her new face swelled and blushed. These episodes were successfully treated, but over the past month, doctors found that some blood vessels on their faces narrowed and closed, resulting in the death of facial tissue. If the damage progresses slowly, Tarleton could be put on the waiting list for another donor face. In the worst case, the tissue would dying quickly and the doctors would have to remove it and reconstruct their original face.

"We all know we are in unknown waters," Tarleton said. "I would rather not have to go through a catastrophic failure."

It will take at least a month for Tarleton to be investigated and a second transplant decision made, doctors said. Apart from the setback on the face, an artificial cornea recently transplanted into the left eye failed and almost blinded her.

"These are not ordinary things that go wrong, but if something goes wrong, you have to deal with it. "She said," I'll go back to where I was, like, I do not know, I'll go through that. "


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