Three Chinese doctors are vying to carry out the country's first face transplant.
Medics in France made history last month when they carried out the world's first partial face transplant on a woman who was injured by her dog.
It has now emerged a trio of doctors in China Li Qingfeng in Shanghai, Hong Zhijian from Jiangsu Province and Chen Huanran of Beijing are looking to take the procedure to the next level, the Beijing News Daily reported yesterday.
Li, of the Shanghai No 9 People's Hospital, affiliated to Shanghai Jiaotong University, declared on December 1 that he is brooding over a whole face transplant, which is expected to take at least 12 hours to perform.
Six days later, Hong, from Nanjing General Hospital of Nanjing Military Command, said he was looking for volunteers to be his first face transplant recipient.
He said the patient would be exempt from the operation costs of 200,000 yuan (US$24,660), and he had received more than 100 inquiries within several days.
And on December 13, Chen from the Plastic Surgery Hospital under the Chinese Academy of Medical Sciences, announced he had finalized his choice of his first face transplant patient, a former worker who was disfigured by spilt liquid iron.
The doctors all claim they have the full skills and facilities to carry out complete transplants on the Chinese mainland.
They are expected to cost about 600,000 yuan (US$74,000), covering the operation itself and post-surgery care.
Costs of the immunosuppressant drugs the recipient must take for the rest of their life to control rejection of the donor tissue will be at least 400,000 yuan (US$49,300).
The junction of the skin graft, fat, veins, nerves, arteries and muscles between the donated face from the dead person and that of the recipient needed be done in a perfect manner, Li told China Daily in a telephone interview yesterday, adding that all the process will be done by micro surgery instruments.
He said the surgery would call for incredible precision on even a thin nerve ending, as a single mistake could lead a "smile" into a "sinister smile," said Li.
"Our experiments showed that the transplanted face on the recipient will look like his/her former face," Li said.
"China could have been the first country in conducting the ground-breaking transplant," Li told the Beijing News, adding that his hospital launched an "inter-human whole face transplant" research project as early as March 2003 with the Shanghai local government and the Ministry of Education. Their face transplant experiments on dogs have been all successful, he said.
Li's team carried out a successful quasi-face transplant on a Shanghai man surnamed Wang last June by reconstructing a face on him with skin from Wang's back.
Hong Zhijian said his technology to perform face transplants has been available since 2004, and that his team could start the procedure as soon as they found a person who had given consent before their death.
Their face would need to be stripped off, together with skin and nerves, between 6 hours and 8 hours after death.
However, the doctors also voiced concerns on issues surrounding the procedure. The first is the lack of national guidance defining who could be the recipients, Chen told China Daily in a telephone interview.
The operation could only be conducted on those who are clear of any criminal activities, and with serious disfiguring conditions, which traditional plastic surgery methods cannot repair, said Li.
Ethical concerns on the matching of the skin colour and texture between donor and recipient would also need to be addressed, said Chen.
Li's hospital in Shanghai has launched a fund to help possible face transplant recipients because of the high cost of transplants. They have already received about 600,000 yuan from social donations.
Hong warned the immunosuppressant drugs people would need to take could cause cancers.
(China Daily December 21, 2005)
