Local Doctor Helps Advance Face Transplant Surgery

Surgery Successfully Tested On Rats

November 30, 2004

DURHAM, NC -- A Duke University doctor is helping to advance research for a revolutionary surgical procedure that could offer hope to victims of catastrophic injuries like burns or gunshot wounds.

Dr. Scott Levin has worked in the area of plastic surgery for more than 15 years. He told NBC 17 that over the past 40 years progress in the field has been tremendous.

"Artificial materials, artificial skin, survivorship of patients, improved quality of life, and particularly the impact of what we call reconstructive microsurgery. That's using the microscope to transplant one part of the body to the other," Levin said.

Levin said those surgical procedures have done wonders, but surgeons want to do more. So, he's helping researchers at The Cleveland Clinic study techniques referred to as face transplantation.

It sounds like science fiction, but it could change the face of plastic surgery, literally.

"The way we would do that is with what we call composite tissue allotransplantation," Levin explained. "Which means we take body parts from someone else, somebody who's deceased..."

Levin said that means it is even possible to transplant the face of a donor to the skull of a recipient. Patients, however, would not look exactly like the donor.

"The brain activates muscles of facial expression and the bone structure that is the platform. It's the facial skeleton, in many ways, that dictates appearance," Levin said.

But is the public ready for that?

"If your child, 6 or 7, had a horrible injury -- and these children exist in this country and around the world -- let's say they've been burned over 90 percent of their bodies, but they survive," Levin said. "The distortion and the calamity of such an occurrence, whether it's from trauma, a burn or a tumor, is inordinate. You just can't measure it. My passion is to have this type of technology to offer patients like that."

Dr. Scott Levin

The biggest concern when dealing with transplantation is the threat of rejection.

Dr. Bradley Collins is a surgeon at Duke who specializes in organ transplantation. He said a cocktail of drugs helps patients accept their transplants.

"I think the most important role that transplant surgeons will play will be assisting the plastic surgeons by providing immunosuppression," Collins said. "Immunosuppression is how we suppress the immune system to prevent rejection."

Unless the donor is an identical twin, the patient's body would treat the transplant as an invader and then try to get rid of it.

"Basically there are cells in our bodies that attack the organ, and these medications prevent those cells from functioning properly."

Levin said the technical side of the equation is complete and a face transplant could be done at Duke right now, but it will still be some time before this sort of surgery is performed on a human.

"The issues are: What immune suppression protocol is the patient going to be on; what are the ethical issues; and what are the long-term issues for the patient," Levin said.

The surgery has successfully been performed on rats at The Cleveland Clinic.

Doctors said the surgery is not for everyone, so, if the technique is approved, there will be a selection process.

Copyright © 2004 by NBC17.com.

This article posted December 9, 2004.