Full face transplant gets go-ahead in UK

The world's first full face transplant is possible within months after British surgeons got the final go-ahead yesterday to perform an operation regarded as the holy grail of plastic surgery.

The UK Face Transplantation team at the Royal Free Hospital in London received permission for four transplants from the hospital's Research Ethics Committee.

"We can now begin to evaluate patients and draw up a shortlist of four people who want to undergo this procedure," said Peter Butler, the plastic and reconstruction surgeon who will head the team.

People whose faces have been destroyed by fire, accident and infection could be among those to benefit.

Surgeons in France performed the first partial transplant in a 15-hour operation last year on Isabelle Dinoire who received a new nose, lips and chin after being mauled by her dog.

Mr Butler said his team have developed psychological and surgical selection criteria to make sure they select the right patients for the surgery.

"We will continue to take a cautious and careful approach and we will not be rushed. It may be many months before we are ready to carry out an operation," Mr Butler said in a statement.

The ethics committee said it reached its decision after reviewing a decade of research results by Mr Butler and his team.

"Ground-breaking research is always difficult and there will always be doubters and detractors," said Andrew Way, chief executive of the hospital.

"Face transplantation has been shown to be a successful treatment elsewhere and our team will now be able to begin the latest and most difficult phase of their work."

The pioneering surgery on Ms Dinoire by Professor Bernard Devauchelle and his team at the Centre Hospitalier Universitaire Amiens in northern France sparked an ethical debate and raised questions about the psychological impact of the procedure on both the recipient and the donor's family.

Although the microsurgery techniques needed for a full transplant are well established, little is known about the psychological impact and the long-term risk of the drugs the patient will take to avoid rejection of the new face.

Changing Faces, a charity that represents people with disfigurements, said it would have preferred the decision to have been delayed until the Royal College of Surgeons updated their recommendations on face transplants.

"Our main concern is to ensure that any patient who is being considered for this procedure has a full understanding of the risks and benefits, especially the risks associated with the immunosuppressant drug regime," the charity said in a statement.

Other experts welcomed the decision.