September 1st, 2014

Face-off: Doctors prepare to carry out world's most complicated full face transplant

Top StoriesBy Sunday World
Luis Casaramona and his daughter Frida.
Luis Casaramona and his daughter Frida.

Doctors in Spain are preparing to carry out the world's most complicated-ever full face transplant.

Dad-of-one Luis Casaramona (44) will get new jawbones, lips ears, hair, teeth, tongue, muscles and nerves as well as a new face once a donor is found.

The former stock exchange worker suffers a rare arterio-venous malformation which causes his blood vessels to swell and haemorrhage.

Joan Pere Barret, who carried out the world's first full face transplant, is helping Luis find a donor so the pioneering op can take place.

Medics have likened the op to a head transplant because the only body parts he will keep from the bottom of his neck upwards will be his eyes, brain, part of his skull and some nerve endings.

The procedure has been described as more complex than a 36-hour March 2012 op on American Richard Lee Norris, who received the world's most extensive facial transplants to date after suffering a gunshot wound.

Barcelona-born Luis, who lost part of his tongue when he cheated death during a haemorrhage soon after his 1994 diagnosis and is now housebound, said: "I have to do something.

"The operation will give me my life back if it works. 

"And if I die at least I will go down fighting."

Doctor Barret added: "Nothing like this has ever been done before.

"When I described Luis's case to the woman in charge of processing hospital transplants, she said: "He's not looking for a face, he wants a new head."

A team of around 50 health workers will take part in the high-risk op, expected to take place at Barcelona's Vall d'Hebron Hospital.

Luis is being supported by his Mexican-born wife Serena, 38, and their daughter Frida, 11, while he waits for a donor to be found.

As well as losing part of his tongue to his illness, he has also been fitted with a permanent tracheostomy tube and been treated with controversial drug Thalidomide.

Before agreeing to a transplant, he had started chemotherapy in his desperate bid to find a cure.

Since he was first diagnosed in the mid-nineties after suffering a tongue haemorrhage, he has spent thousands of euros on medical bills.

Law graduate Luis had to give up his job as a stock exchange worker 20 years ago and has been receiving incapacity benefits since he was 28.

He has already met Oscar, the Spanish farmer who in March 2010 received the world's first full transplant in an operation led by Doctor Barret.

Oscar, 34, was disfigured in a shooting accident in 2005. He has never been fully named.

He bravely showed off his face to photographers four months after his op with his unnamed sister declaring at the time: "He is looking forward to doing the normal little things in life again, the things we do every day without having any problems - things like walking down the street without people looking at him five times."

French woman Isabelle Dinoire was the first person to receive a face transplant in 2005 after she was savaged by her dog.

Doctors transplanted a triangle of facial tissue around her nose and the mouth including muscles, arteries and veins.

The world's first full world transplant took place in Spain in March 2010.

Spain is a world leader in organ and limb transplants.

One of its most famous doctors is Pedro Cavadas, who famously kept a patient's arm alive by temporarily implanting it onto his leg and in another op converted a one-handed patient's right hand into a left hand so he could move it from his right arm to his left one.

In July 2011 Valencian-born Cavadas performed a world-first double leg transplant.

The patient's legs had to be amputated after he suffered an unrelated illness which forced him to stop taking anti-rejection drugs.

By Gerard Couzens