No Ethical Barriers to Face Transplant in Children, Experts Conclude

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Should children be considered for facial transplantation? While there are some special ethical and psychological concerns, these shouldn’t rule out the possibility of performing face transplant in carefully selected children, according to an expert review in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Our analysis finds no physical, psychological, or ethical barrier that disqualifies children from undergoing face transplantation,” comments Alexandre Marchac of Hôpital Européen Georges-Pompidou, Paris, lead author of the new report. He adds, “Pediatric face transplantation will likely occur in the near future.”

While facial transplantation remains uncommon, the procedure has advanced rapidly, with several transplant teams around the world reporting excellent results. From the earliest debates over face transplantation, children have been excluded from consideration.

And yet, there are children with severe facial disfigurement who could potentially benefit from facial transplantation. Toward considering the possibility of expanding their face transplant program to include children, Dr. Marchac and colleagues performed a review and analysis of the clinical, psychological, and ethical issues that would be involved.

An expert panel including transplant surgeons, medical ethicists, and a child psychologist identified and debated issues related to offering facial transplantation in children. Out of twelve possible patients included in an in-depth review, three were identified as potential candidates for face transplant. All had severe facial disfigurement–caused by congenital malformations, diseases, or burns or other trauma–with “very poor” expected outcomes from conventional reconstructive surgery.

In children as in adults, the decision to perform facial transplantation would depend on the balance of risks and benefits. Because they heal faster, children might be expected to have even better recovery of facial sensation and movement than adults. Because of continued growth of the facial skeleton, some children may need additional craniofacial surgery years after the face transplant.

Read the full article at:  http://www.eurekalert.org/pub_releases/2016-08/wkh-eb080116.

Find the journal article at:  http://journals.lww.com/plasreconsurg/Fulltext/2016/08000/Ethical_Issues_in_Pediatric_Face_Transplantation__.31.aspx

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