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Story Highlights=95 First partial face = transplant was=20 performed in 2006=95 Siemionow has clearance from The = Cleveland Clinic=20 to perform a full transplant =95 Candidates for the face = transplant would=20 be burn or accident victims By Miriam =
Falco
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![3D"Decrease](3D"http://i.a.cnn.net/cnn/.element/img/1.5/story/misc/icon.minus.gif"= "3D\"Decrease"){kind=icon} ![3D"Enlarge](3D"http://i.a.cnn.net/cnn/.element/img/1.5/story/misc/icon.plus.dim.g= "3D\"Enlarge"){kind=icon} For more on face transplants and some = other medical=20 predictions for the next year, tune into a special edition of = "House Call=20 with Dr. Sanjay Gupta: Prognosis '07" on Saturday & Sunday at = 8 am=20 ET. (CNN) -- After a partial face transplant was performed in 2005, = it=20 seems a full face transplant will be the next breakthrough. One surgeon likely to be the first to conduct the = reconstructive=20 procedure is Dr. Maria Siemionow, from the Cleveland Clinic. Trained in Poland, Siemionow's first microsurgical operation = was=20 reconnecting someone's hand. She said it was a very powerful experience that "led me to = think that=20 technically we can do so much and you can make patients that are = disabled=20 one day ... come back to society the next day." With the development of better microscopes and instruments and = a lot of=20 practice using them, connecting the tiniest blood vessels and = nerves is=20 now possible. Siemionow said the idea of a face transplant evolved from her = interest=20 in reconstructive surgery. "As a hand surgeon I would think, 'We can really make hands = functional=20 but there is so little we can do for ... faces.'" The Cleveland Clinic gave Siemionow the medical and ethical = clearance=20 for a full face transplant in 2004, making her the first in the = world to=20 receive the greenlight for this experimental procedure. Yet, two years later, Siemionow has yet to do the surgery. That's because she hasn't found the perfect candidate. "I think that is a very important statement that the selection = criteria=20 is taking time," Siemionow said. Appropriate candidates would be burn or accident victims who = have=20 exhausted all other reconstructive possibilities. For the = transplant, the=20 entire skin flap of a patient's face and possibly parts of the = scalp, ears=20 and neck would be replaced. Patients have to fulfil a lot of criteria. They would have to = take=20 immune-suppressing drugs for the rest of their lives to prevent = tissue=20 rejection. They would require a built-in escape clause. "One of the most important things is that the patient who is a=20 candidate for facial transplantation requires enough skin in their = own=20 body, where we can actually rescue them or have an exit procedure = in case=20 the face transplant would be rejected," Siemionow said. So the search for the perfect patient continues -- as does the = race to=20 see who will be first to conduct the transplant. French and Chinese surgeons have already reached the partial = transplant=20 milestone and a British surgeon announced he's ready to do the = first full=20 face procedure. But he's only received permission to find a suitable candidate, = not to=20 perform the operation. Siemionow strongly believes it's important = to=20 explain to the public what a full face transplant is about and = what it's=20 not about. For one, she said, it's not about vanity. "I got a phone call = from=20 someone very young who said, 'I have this terrible acne, and I = heard at=20 Cleveland Clinic, you have this new thing going on -- face = transplant --=20 would I be a candidate?'" "It should be considered a medical procedure. This is something = we want=20 for the wellbeing of our patients and only those who cannot be = treated by=20 conventional ways." Siemionow is looking even further into the future -- = transplanting=20 facial tissue and bones too. She's just published research doing just that on mice, which = the=20 American Society of Plastic Surgeons describes as a "step closer = to making=20 the reconstructive process easier for patients with extensive = skull and=20 facial deformities."
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