Facial transplantation: a working party report from the Royal College of Surgeons of England

Facial Disfigurement and Identity: A Review of the Literature and Implications for Facial Transplantation

“…Concerns are rooted in the knowledge that the face plays an essential role in personal identity and self-recognition [11,49,82,83,[87][88][89] and is a critical mediator of self-expression and interactions with others [82,90]. Advocating that the face is as an irreplaceable symbolic entity, the Royal College of Surgeons of England [87] and the French National Consultative Ethics Committee for Health and Life Sciences [82] did not initially support FT. A review of all scientific literature related to FT published between 2005 and 2012 found that the majority of articles cited negative "identity change" and resulting psychological effects as the primary concern [11]. Robertson argues that skepticism about FT stems partially from the fact that it involves continuation of the deceased donor in a unique way that does not apply to solid organ donors [84].…”

“…Nonetheless, over the last decade, various groups have scrutinized and explored the ethical [79][80][81][82][83][84][85] and psychosocial [11,49,82,83,[86][87][88] aspects of FT along with its effect on self-concept. Concerns are rooted in the knowledge that the face plays an essential role in personal identity and self-recognition [11,49,82,83,[87][88][89] and is a critical mediator of self-expression and interactions with others [82,90].…”

The Psychology of Facial Disfigurement: Implications for Whole Face Transplantation

“…The psychological literature available to inform the discussions of the first Working Party included studies relating to psychological responses to various types of organ transplantation and a smattering of commentaries relating to the impacts of hand transplants [1]. These studies included reports of raised levels of post-procedural anxiety relating to the short-and longer-term viability of the transplant, the aftermath of possible rejection and the potential and actual side effects of immunosuppression.…”

“…In 2004, the Royal College of Surgeons Working Party on Face Transplantation published a report on the technical, immunological, ethical, psychological and legal aspects of facial transplantation [1]. Members appreciated the extent of psychological distress experienced by potential candidates for a whole face transplant (WFT) and were of the opinion that WFT had the potential to be a major breakthrough in relation to aesthetic outcomes; however, major concerns were expressed about the potential consequences and side effects of lifelong immunosuppression.…”

Facial Transplantation

“…It has been suggested that face allotransplantation could be a reconstructive alternative for patients with facial deformities that cannot be addressed through the application of currently available reconstructive procedures. [30][31][32][33][34][35][36][37][38][39] TECHNICAL APPLICABILITY AND FEASIBILITY OF FACIAL/SCALP TRANSPLANTATION: OVERVIEW OF THE LITERATURE Reconstructive surgeons attempting to transplant facial allografts must address not only technical issues but also several other chiefly nontechnical issues, specifically (a) determining, feasibility, and applicability of face transplant; (b) developing protocols for lifelong immunosuppression; (c) discerning ethical, social, and psychological concerns; (d) obtaining institutional review board approval; (e) identifying appropriate recipients thorough a screening process based on specific inclusion and exclusion criteria; and finally (f) finding appropriate donors. 1,3,15 The vascular anatomy of the human face is wellknown.…”