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UPMC/University of Pittsburgh Schools of the Health Sciences

Face Transplant Fact Sheet

History and Evolution of Face Transplantation

The world’s first partial face transplant was completed in 2005 in France. At five years, the patient, whose tissues were damaged in a dog attack, is the longest surviving face transplant recipient. The first full face transplant in the United States was successfully completed in 2008 and the second in 2009.

Researchers at UPMC believe that reducing the number, dosage and frequency of drugs will significantly minimize the adverse effects of immunosuppression, thus optimizing the life-enhancing outcomes of face transplantation. In doing so, composite tissue allotransplantation (CTA) researchers can increase the clinical applicability of face transplantation and achieve the goal of making it a routine reconstructive surgical procedure for patients suffering from major facial injuries.

Immunosuppression in Face Transplantation – The Pittsburgh Protocol

The treatment protocol at UPMC has been successful thus far in hand transplantation as well as in kidney and liver transplants in reducing drug treatment after surgery. The goal of the current study is to reduce the long-term risks of the conventional triple-drug therapy used to prevent the body from rejecting transplanted organs and tissues.

The risks of high dosages and combinations of anti-rejection drugs are well documented.  Because these drugs have to be taken for as long as the person retains the transplanted tissues, doctors are especially concerned about their toxic side effects, which can include hypertension, diabetes, increased risk of infection,  liver and kidney dysfunction and increased risk of developing certain types of cancers. Unlike a liver or heart transplant, where the life-saving benefit outweighs the risk of lifetime use of anti-rejection drugs, a similar argument for a non-life saving transplant like a face or hand has been problematic. 

Building on decades of immunology research at the Thomas E. Starzl Transplantation Institute at UPMC, the Division  of Plastic and Reconstructive Surgery at UPMC has developed a treatment protocol based on a two-phase regimen that it believes will enable patients to be treated with a reduced dosage of anti-rejection drugs for the long-term.

Patients in the UPMC program receive a bone marrow infusion from the donor shortly after the face transplant. Researchers deliver the bone marrow at this point to help the recipient overcome the initial overwhelming immune response against the transplanted facial tissues. The bone marrow cells target specific cells that could reject the new tissues and help “re-educate” the immune system so that the transplanted tissues are attacked as a foreign object. Patients will be treated with tacrolimus, a drug that was first used in liver transplants by Dr. Starzl over two decades ago.  Tacrolimus has successfully prevented rejection at low doses and at reduced frequency in hand, kidney and liver transplants performed at UPMC.

UPMC Face Transplant Program

Currently, the division is seeking participants with significant facial injury, trauma, deficits or deformities to enroll in their face transplant study. Patients must be between the ages of 18 and 65 and have tissue structure damage including, but not limited to, mid-face structures such as the eyelids, nose and lips.

Patients should expect to undergo extensive therapy following the transplant to regain function and movement in the transplanted tissues.  They will also have to remain in the Pittsburgh area for up to three months following surgery to be closely monitored and treated for signs of rejection and to participate in intensive rehabilitation therapy.

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