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The face transplant recipient's donor face now fails

A woman who burned badly in a Vermont violence attack is hoping for a second face transplant after a doctor recently discovered tissue damage that is likely to result in the loss of her donor face.

Carmen Blandin Tarleton, 51, 2007 burned over 80% of her body when her estranged husband doused her body with lye after striking her with a baseball bat. Six years ago, she received a facial transplant at Brigham and Women's Hospital in Boston, where she is being evaluated for a possible second transplant.

Tarleton, who now lives in Manchester, NH, told the Boston Globe that she has no regrets about transplantation because it dramatically improved her life. She has learned to play piano and banjo, wrote a memoir and has talked to many groups about her life. She lost 20 pounds and started walking five miles a week.

"I had such a low quality of life before my face transplant. Do I wish it had lasted 1

0 or 20 years? Of course, she said.

More than 40 patients worldwide have had face transplants, including 15 in the United States. None of the American patients have lost their donor surfaces but last year, a French man whose immune system rejected his donor face eight years after his first transplant underwent a second.

Tarleton's physician found that most transplanted organs have limited lifespans. But her situation is a reminder that, despite successes in the field, face transplantation is experimental and still a young science with many unanswered questions about benefits versus long-term risks.

"There are so many unknown and so many new things we discover," says Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham and Women & # 39; s and one of Tarleton's surgeons. Still, he said, "It's really not realistic to hope that the faces will last (patient's) life. "

Dr. Brian Gastman, a transplant surgeon at the Cleveland Clinic who did the first American face transplant 11 years ago, said more patients are beginning to experience chronic rejection. "We all believe that every patient will probably need a replant," he says.

Since her transplant in February 2013, Tarleton has had repeated rejection episodes when her new face became swollen and red. These sections were successfully treated but last month discovered doctors that some blood vessels in the face had narrowed and closed, causing the facial tissue to die. slowly can Tarleton go on the waiting list for another donor. In the worst case, the tissue would die quickly, and doctors had to remove it and reconstruct her original face.

"We all know that we are in uncharted waters," Tarleton said. "I'd rather not have to go through a catastrophic failure."

It takes at least a month to evaluate Tarleton and make a decision about a second transplant, doctors said. Apart from the backlash with her face, a synthetic cornea recently transplanted into her left eye failed, leaving her almost blind.

"These are not common things to go wrong, but when things go wrong you have to deal with it," she said. “I'll be back where I was. How do I not know. I'm going through this. ”

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