Page 28 - ARUBA TODAY

A28 SCIENCE
Tuesday 21 February 2017

Are face transplants still research, or regular care?

BY MARILYNN MARCHIONE procedures and the cost
AP CHIEF MEDICAL WRITER would be 30 to 40 percent
Is replacing a severely dis- higher, Mardini said.
figured person’s face with Hospital management
one from a dead donor and multiple committees
ready to be called regular reviewed the case, includ-
care, something insurers ing an ethics panel, a so-
should cover? Mayo Clinic cial worker and transplant
has raised that question psychiatrist, to ensure
by doing the first U.S. face Sandness knew the risks
transplant that’s not part and was giving informed
of research. consent.
Faces, hands, wombs and “It’s critically important
even a penis have been that he understand what
transplanted in recent he would be putting him-
years. self through,” Mardini said.
Unlike liver or heart trans- Sandness’ insurance com-
plants, these novel proce- pany would not agree in
dures are not life-saving advance to pay; so, a fund
but life-enhancing. from a donor to start a
Who pays for care that hand and face transplant
can cost $700,000 or more center at Mayo paid. Talks
is a growing concern. Eth- on paying for after-care
ics and liability issues also are ongoing.
may arise when they’re The long-term medical
done without the oversight and psychological effects
of an institutional review In this Wednesday, Aug. 24, 2016 file photo, former Mississippi firefighter Patrick Hardison, 42, cen- will be studied as part of
board, a hospital panel ter, views a video showing progression of his face transplant, during a press conference marking formal research, even
that ensures research par- one year after his surgery, at New York University Langone Medical Center in New York. though the operation itself
ticipants’ rights are pro- was not, Mardini said.
tected. policy. of Pennsylvania surgeon first face transplant. World- “I don’t particularly agree
The group that runs the na- “It’s time to come together who heads the UNOS pan- wide, roughly two dozen with the argument that it’s
tion’s organ transplant sys- and really ask the question, el on this. have been done, about not research,” said bioethi-
tem, the United Network ‘Is this going to become a He has done several hand half of them in the U.S. Four cist Arthur Caplan, who
for Organ Sharing, plans a standard of care?’” said transplants and no longer recipients have died. advised New York Univer-
conference to help guide Dr. Scott Levin, a University considers them experi- At Mayo, “we wanted to sity on its first face trans-
mental, though insurers do it as a clinical program” plant, in 2015.
won’t pay. Worldwide, and felt there was no re- There’s a higher bar to en-
about 100 hand, face or search question to be an- suring informed consent for
other, newer body-part swered because the op- research versus a new ther-
transplants have been eration uses standard sur- apy, and “questions about
done, and “that’s not a lot gical techniques, said the competence, experience
of cases” to judge safety plastic surgeon who led and even liability are dif-
and effectiveness for some it, Dr. Samir Mardini. With- ferent” when something
types, he said. out a transplant, Sand- is called regular care, Ca-
Andy Sandness’ opera- ness would have needed plan said. “In my view it’s
tion last June was Mayo’s 15 other reconstructive still highly experimental.”q