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Interview: Face Face-Transplant Program Will Help to Restore Devastated Lives STORY HIGHLIGHTS UCLA’s Face Transplant Program is one of only a handful in the nation. Facial transplantation offers the capability to restore features that are too damaged by trauma or fire to restore through conventional reconstruction. “Face transplantation offers the potential to restore humanity to persons who have suffered the devastating loss of their face.” UCLA Health is the first center in the western United States to offer facial transplantation to qualified patients who cannot be adequately treated using conventional reconstructive techniques. The UCLA Face Transplant Program is one of only a handful in the nation to offer this still-experimental innovative treatment. Facial transplantation is a complex procedure that is part of the emerging transplant field called vascularized composite allotransplantation (VCA). This is the transplantation of skin, blood vessels, nerves, bone, muscle and other supportive structures from a donor to a candidate. To accomplish this, the UCLA program has assembled an outstanding team of specialists, including those in plastic and reconstructive surgery, head and neck surgery, microvascular surgery, occuloplastic surgery, neurosurgery, oral surgery, dentistry, psychiatry and transplantation medicine. Kodi Azari, MD, FACS, chief of reconstructive transplantation, talks about the program. How did this program evolve? UCLA has been involved over the past several years with the U.S. military through Operation Mend, providing reconstructive surgery to service members wounded in Iraq and Afghanistan. Our face-transplant program grew from our desire to do more for our wounded service members. The face is the most exposed body part and is integral to our sense of self. So you can only imagine what it’s like to not have a face. Face transplantation offers the potential to restore the sense of self to persons who have suffered the devastating loss of their face. People with massive facial injuries often have trouble breathing, speaking and eating, as well as depression and social isolation. Early surgeries have demonstrated very promising results in improving both appearance and function. While the program is an outgrowth of our relationship with the military, it will accept both civilians and veterans as candidates. What are the criteria to become an eligible candidate for face transplantation? The first requirement is that the patient’s facial disfigurement cannot be the result of cancer and, in spite of repeated attempts, cannot adequately be reconstructed by conventional means. We can do amazing things through reconstructive plastic surgery, but there are injuries from trauma or from burns that are just beyond our capabilities to restore. Facial transplantation offers us that capability. Appropriate candidates must be between 18 and 60 years of age, have no serious infections, including hepatitis B or C or HIV, and be in otherwise generally good health. In addition, candidates must commit to extensive rehabilitation, adhere to an immunosuppression medication regimen, and participate in all appointments at the transplant center. Patients needing an organ transplant can spend years on the waiting list before an appropriate donor is found. What are the challenges of matching an appropriate donor and recipient for this procedure? Finding the right donor is a challenge, and this is such a new field that there is no streamlined way for finding donors. We would like to push for a national database, like what exists for organ UCLAHEALTH.ORG 1-800-UCLA-888 (1-800-825-2888)