First British face transplant 'within a year'

Jacqueline Saburido is among the 20 disfigured people who have approached surgeons at a London hospital to carry out Britain's first face transplant operation. She was badly injured six years ago, when she visited America from Venezuela to study English.

Jacqueline Saburido is among the 20 disfigured people who have approached surgeons at a London hospital to carry out Britain's first face transplant operation.

She was badly injured six years ago, when she visited America from Venezuela to study English.

On Sept 19 1999, Jacqui - then 20 years old - and four friends were on their way home from a birthday party when a drunken driver collided with them, killing two passengers.

She was burned over 60 per cent of her body; her fingers had to be amputated and she lost her hair, her ears, her nose, her left eyelid and much of her vision.

She has had more than 50 operations since the crash and has many more to go.

In London, Peter Butler, a consultant plastic surgeon who has been researching face transplant surgery for nearly 12 years, is leading a 30-strong team at the Royal Free to carry out the first UK transplant.

"We have ethical approval to select patients. We have had a number of inquiries," he said yesterday, adding that Jacqui Saburido was among those who had approached him.

In Louisville, Kentucky, specialists rebuilt the eyelid that she lost in the fire and carried out a cornea transplant in 2003 to enable her to see out of her left eye.

She now lives in Miami, where she continues to have plastic surgery, and campaigns against drunk driving.

From the patients who have approached the London team, Mr Butler hopes to identify five patients initially and says that the first British operation could take place within a year.

While the ethics committee of the Royal Free Hospital has agreed to the next stage in a long process it will still want to see details of the candidate patients.

Assessment will probably take place next week, or probably in January. "We have agreed that to be eligible, patients would have a severe facial deformity as a result of burns or an accident, that the injury would impair normal function in some way and that there would be some psychological distress," he said.

They still had to agree with the ethics committee how donors or donor families would be approached.

"There have been many concerns about identity. Families want to know if they would recognise the dead donor if they saw the recipient walking down the street. We have been able to show using simulations that this does not happen."

The team has used computer aided reconstructions to show that a transplanted face will look different, due to the effects of underlying bone structure: in such studies, Mr Butler has exchanged faces with a psychologist on his team, Dr Alex Clarke, who helps people adapt to disfigurement.

Donors and recipients will also need to be matched for age, sex and skin colour.

To do the operation would cost around £20,000, said Mr Butler, plus another £5,000 per year for drugs to prevent an immune attack on the transplanted tissue.

Last month French surgeons performed the world's first face transplant on Isabelle Dinoire, 38, part of whose face had been torn off by a dog. In her partial face transplant she received the lips, nose and chin of a donor.

At present, burnt faces are rebuilt using thin grafts and thicker flaps of skin and muscle from other parts of the body.

While this avoids the rejection of foreign tissue, a face formed out of tissue from the back - with slits for the eyes and mouth - is far from convincing. And it takes more than 100 operations.

In many ways these are more demanding than a straightforward face transplant, which would require only a few ops to achieve a better result, a working face with movement and expressiveness.

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