When it comes to hand and face transplants, much is still unknown. The first facial procedure was completed just over five years ago, and since then just seven have been performed in three U.S. hospitals. Twenty patients have undergone hand transplants. Public interest is slowly increasing, though there is a tremendous amount of groundwork to be completed before these two procedures will be considered a widespread solution.
Establishing a national database of these patients with detailed records about their health history before and after surgery is most certainly a priority. Defining success after going through one of these types of transplants is tricky, since they are not life-saving processes. In the case of traditional organ transplants, for example, the life of the organ within the recipient is a trackable way to determine success. In the case of a face or hand, medical professionals may monitor things like appearance, acceptance by the body, and the ability to hold a pen and write.
Right now, insurance agencies won't pay for these types of procedures. Due to the lack of knowledge about them, they're considered experimental. Likewise, organ collection agencies are not prepared to support the practice. They aren't trained in collecting and transporting these body parts, and their staff don't know how to offer this as an option to donors and their families.
Another component that will need to be addressed in the coming years is establishing guidelines for who should go to the top of the waiting list for faces and hands. Some argue that children should receive priority because their nerves regenerate faster, which means they're more likely to have positive outcomes. Others contend that those with the most severe disfigurements or who were hurt while on active duty should be considered priority patients.
This area of transplant surgery will most certainly expand in the coming years. As more surgeons become involved in the discussion and in the practice, the number of successful procedures and proven results will continue to grow.
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