Tag Archives: transplant

Robot performs hair transplant

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Los Angeles: A robot that performs hair transplants more naturally than humans has been developed by a Californian company.

Restoration Robotics, says its robot can also pluck and move individual hair follicles twice as fast as humans, with less pain and scarring for the patient.

At the moment a surgeon must carry out a very time consuming and repetitive procedure of removing a strip of hairy scalp, separating it into individual hair follicle “bulbs”, and painstakingly implanting them in one millimeter wide incisions across bald parts of the head, according to an article in New Scientists magazine.

The robot plucks healthy follicles individually, at a rate up to 1000 an hour. He revealed that a one millimeter hollow needle removes the follicles using suction. Guided by cameras and 3D imaging software, the device is mounted on an arm normally used to place microchips on circuit boards

Officials at Restoration Robotics claimed that, while manual transplants might take around eight to 10 hours, their robot could complete the process in about five hours. The robot also had the ability to design a patient’s hairline on a computer, which could be important for giving the transplanted hair a more natural look.

The robot, which is currently honing its skills on volunteers, is expected to be used in full clinical trials later this year.

UK surgeon gets go-ahead for first face transplant

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London: Prof Peter Butler, a plastic and reconstructive surgeon, has been given the go-ahead to carry out four face transplants with injuries that conventional surgery has no more to offer.

A new charity, The Face Trust, was also launches yesterday to raise the £25,000 for each operation and the anti-rejection drugs.

Permission was granted by the ethics committee of London’s Royal Free Hospital, London, and will now select four patients for the first, ground-breaking operations.

Prof Butler said he would now begin “the more important task, the selection of the right patients”. It will be a year before the first operation takes place.

The first partial face transplant was conducted in France last year when Isabelle Dinoire, 38, who had been savaged by a dog, received the lips, nose and chin of a donor. Her surgery was successful and she began to regain sensation within weeks.

Prof Butler’s team has already been approached by potential patients and sought the help of the French team.

Prof Butler said he was looking at patients who had already lost all their facial tissue and for whom further plastic surgery had nothing to offer.

“In other words, surgeons cannot work on them any more. They may have problems with eyelid and mouth opening and closure, they may not have any hair, their ears may have gone, been destroyed or damaged.

“Most of them just want to be able to walk down the street without being stared at. The French say their patient says she can walk down the street and no one looks at her. It is actually what she wanted to do. You can’t say more than that,” he said.

Each operation will take 12 hours and involve six surgeons working with the donor and the recipient.

If an operation fails, their research has shown that the patient would be no worse off, Prof Butler said. The patient could be offered another transplant, treatment with artificial skin or more standard plastic surgery.

The team will wait for six months after the first operation before attempting a second. He said there had been no cases of acute rejection in 24 hand transplants.

Prof Butler said donors would be people on the national donor register. Recipients and donors would be matched for tissue type, as with organ transplants, but also for skin colour and tone and gender.

French surgeons have reported bereaved families offering faces to transplant co-ordinators since Ms Dinoire’s surgery.

Drug may reverse liver damage even in alcoholics

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Newcastle: Scientists have discovered a drug that could prevent liver disease, even in alcoholics.

Tests on the drug, Sulphasalazine, which is currently used to treat inflammatory bowel disease, found that it also prevented scarring of the liver and even reversed liver damage.

Professor Christopher Day, a liver specialist from Newcastle University in Britain who led the research, said Sulphasalazine could provide an alternative to liver transplants.

“This drug is not a finite resource. You are not stealing it from someone else, which is always a worry in public opinion,” said Professor Day said. “People are dying on the transplant list.”

Until now, cirrhosis of the liver, usually caused by alcohol abuse, is considered incurable and the only option for patients in the final stages of liver disease is a liver transplant.

Many patients die waiting for a transplant and there is a lack of desire to give organs to those who are ill through self abuse.

The researchers have tested the drug on animals and human trials are expected to begin in Britain next year.

The drug will initially be given to heavy drinkers who have given up alcohol too late for their liver to recover naturally.

If this proves successful, the medicine will also be prescribed to alcoholics who continue to drink but show a determination to fight their addiction by reducing intake.

Sulphasalazine may also relieve the ethical dilemma of giving donated livers to people whose illness was self-inflicted through excessive consumption of alcohol or poor diet and obesity.

Professor Jones said 10 to 15 per cent of people on the waiting list for a liver transplant were heavy drinkers.

“It’s a very tough decision for the doctors, if, for example they are faced with a 45-year-old man with a young family who’s a heavy drinker. If you say no to the transplant, they will die.

“It would be revolutionary if this drug could reverse the liver damage so you wouldn’t need to do a transplant or, better yet, prevent the damage in the first place.”

Women given liver transplants outlive male recipients by about four years

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Birmingham: Female liver transplant recipients outlive men given the same procedure by an average of 4.5 years, suggests UK research to be published in the medical journal Gut.

And while younger people tend to live longest of all, they also stand to lose more years of their life compared with those who have not had liver transplants, the research shows.

The research team assessed the life expectancy and years of life lost of 2702 people who had received a liver transplant between 1985 and 2003, and who had survived more than six months afterwards.

The information was taken from the National Transplant Database, held by UK Transplant, and compared with that from healthy people matched for age and sex.

The analysis showed that, on average, after reaching the critical six month period, survival time for liver transplant recipients was 22 years compared with 29 years for the general population.

The life expectancy of male liver transplant recipients was 18 years compared with 26 years for women.

This compares with 27 years for men and 31 years for women in the general population, equating to twice as many years of life lost for male transplant recipients compared with their female counterparts.

Those aged between 17 and 34 had the highest life expectancy of 28 years after a liver transplant. But this compares with a life expectancy of 51 years for their peers in the general population.

Transplant recipients with primary liver disease fared significantly better than those undergoing the procedure because of hepatitis C infection, cirrhosis, or cancer.

The authors note that while one year survival rates have increased over time, death rates beyond this period have remained more or less the same.

They attribute this to the types of patients undergoing the procedure, who now include older, sicker patients, as well as the use of more “marginal” livers.

British hospital’s used stolen body parts in patients

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London: Twenty-five British hospitals have bought tissue which may have been taken from diseased corpses in the UK body snatchers scandal.

And at least 40 British patients have been given transplants using body parts plundered by the mafia gang who stole more than 1,000 bodies from US funeral parlours. Most of the parts have been used in bone and dental grafts.

The body of veteran BBC broadcaster Alistair Cooke was among those stolen. and there are fears that potentially inadequate screening may have exposed British patients to HIV or syphilis.

The Medicines and Healthcare Products Regulatory Agency yesterday named the 25 hospitals where potentially contaminated body parts were grafted into British patients.

It revealed that 82 pieces of bone had been bought to be used in procedures such as hip operations and were distributed to the hospitals by the Swindon-based firm Plus Orthopaedics.

A spokesman for the health watchdog said the risk of catching an infection from the stolen bones was ‘negligible’ as they had been sterilised.

Normally, once tissue has been removed from a donor’s body and screened for disease, it is soaked in various solutions to prevent transmission of bacteria and viruses.

Nevertheless affected patients have been contacted and offered screening for diseases.

The scandal emerged in October last year when it was discovered hat the New Jersey-based company Biomedical Tissue Services (BTS) had been selling bones, ligaments and skin for use in transplants which had allegedly been removed illegally from corpses.

Bone is said to have been taken illegally from American corpses at funeral parlours without consent and without the necessary checks to make sure the bodies were free of disease. Cooke, whose Radio 4 programme Letter From America ran for 58 years, died from lung cancer aged 95 last December.

His bones were cut out and sent to BTS before he was cremated.

BTS owner Michael Mastromarino, who faces body harvesting charges, is said to have paid £500 per corpse.

The company, which has been shut down, supplied bones and other body parts to the NHS. Many of the bones supplied by BTS were recalled after the scandal broke.

The Medicines and Healthcare Products Regulatory Agency, which ensures medicines and medical devices are safe, has tracked down affected patients in the UK and alerted their doctors. It initially-thought 77 parts had been sent to the UK but has now increased the figure to 82.

‘We ensured that affected hospitals were contacted, advising them that the infection risk was negligible, so that clinicians could decide what advice they should give to their patients,’ a spokesman said.

Campaigners called for tougher controls on the import of human body parts into the UK.

Professor Stephen Wigmore, chairman of the ethics committee of the British Transplantation Society, said: ‘No one would want to think they’d received tissue from someone from whom it had been taken against their will. It’s cases like this that highlight holes in the law.’

The scandal has exposed a growing trade in bones and tissue which are harvested abroad and shipped to Britain.

Shortages of organs and tissue from this country have been blamed on the fall-out from Alder Hey and the Bristol babies scandal, where organs were removed without consent.

There are currently no laws governing the import and export of body parts into the UK.

The Government organisation responsible, the Human Tissue Authority, said yesterday that it does not know which countries import skin, bone and ligaments to Britain, nor does it know the quantities shipped.

The American scam was uncovered when a funeral parlour owner in Brooklyn discovered records of the bone theft and called in police.

It was found that the bones of some corpses had been replaced with plastic pipes.

In the case of Cooke, documents listed the cause of death as a heart attack and lowered his age to 85, investigators said.

Mastromarino and three others have pleaded not guilty to the charges

London hospital about to carry out world’s first full face transplant

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London: A British hospital is about to carry out he world’s first full-face transplant.

The hospital’s ethical committee is expected to announce this week that it will approve the first operations.

Royal Free Hospital plastic surgeon Peter Butler has been contacted by 29 disfigured volunteers willing to undergo the procedure.

“My aim is not to be first, but to do it on the right patient,” Dr Butler said.

“It would be very dangerous to look at it as a race because it could harm the patient and (the reputation of) the procedure,” Dr Butler told the Sunday Times. He said one potential candidate was a 22-year-old badly burned as a child.

Last year, surgeons in France carried out the world’s first partial face transplant. Mother of two Isabelle Dinoire, 38, had her nose, lips and chin replaced after being savaged by her dog in May 2005.

In April, a hospital in China conducted what is believed to be the second partial face transplant on Li Guoxing, 30.

Dr Butler’s 30-strong team has spent 10 years studying face transplants.

“We don’t know how people will react. Does the Government want us to go ahead with this? We just don’t know. But a huge amount of work has been done with the group of patients who might benefit.

“Many of them have very disfiguring injuries and spend their lives indoors so for them this is not just life-enhancing surgery, it is life-saving because it gives them back the chance to join society.

“You can do more and more research but at some point the leap has to be made, and people have to say, `OK, we’ve done our preparation, let’s get behind this’.”

Surgeons carry out first face transplant

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Paris: French surgeons have carried out the world’s first face transplant in a controversial medical breakthough.

It was carried out in France on a 36-year-old woman who lost her nose, lips and chin when she was savaged by a dog.

Doctors replaced the central triangle of her face with tissue taken from a donor’s face.

The woman has survived the critical first 48 hours without rejecting the transplant but is still in intensive care. Some experts put the risk of rejection of facial tissue as high as 50 per cent within five to 10 years.

The operation will intensify the ethical and moral debate which has surrounded research into face transplants.

Four teams around the world have been working towards this point but efforts in the UK effectively stalled in 2003 when the Royal College of Surgeons called for more research, saying the psychological impact of failure would be ‘immense’.

The ultimate goal of the pioneers is to replace an entire face.

The operation, believed to have taken around ten hours, was carried out on Sunday and Monday in the northern town of Amiens.

The team was headed by Jean-Michel Dubernard, who carried out the first hand transplant in 1998.

The surgeons worked through the night to remove the facial skin, fat and some blood vessels from a donor in Lille who had been declared brain dead. Permission had been granted by relatives.

The team then placed the graft over the recipient’s face before using microsurgical techniques to connect the tissues. Donated material is superior to skin grafts taken from the patient because facial skin is so different from tissue elsewhere in the body, such as the thigh, as it is finer with a slimmer layer of underlying fat.

The woman, from the northern town of Valenciennes, was disfigured by a dog bite in May and it is believed she had undergone counselling to prepare her for a possible transplant.

The donor will have been matched for facial colouring and skin texture, but the recipient will not take on her appearance because underlying bone structure forms such an important part of an individual’s appearance.

The medical team will be monitoring the patient for signs of rejection. If there are serious complications the tissue will have to be removed.

Even if the operation is a success she will have to take drugs for life to suppress her immune system. These drugs heighten the risk of cancer.

A source at the hospital said ‘The team were very excited after the operation. It is a world first which has massive implications for many badly disfigured people around the world.’

German doctors grow new jawbone from stemcells

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Kiel: A German man was able to chow down on a bratwurst sandwich after surgeons grew a new jaw bone on his back muscle and transplanted the bone to his mouth.

The 56-year-old man had part of his lower jaw removed because of mouth cancer. Until the transplant, his diet was limited to soft food and soup for nine years.

Doctors in Kiel, Germany have rebuilt a man’s face using a new jaw grown on his back.

Dr Patrick Warnke, a reconstructive facial surgeon at the University of Kiel in Germany and his colleagues used CT scans and computer-aided designs to build a virtual jaw replacement.

The researchers used the model to construct a mesh cage, which they filled with bone mineral, protein and stem cells from the patient’s bone marrow. They then transplanted the implant below his right shoulder blade.

Seven weeks later, surgeons transplanted the new bone graft into the mouth gap in the patient’s face.A month after the surgery, he was able to eat his celebratory supper.The experiment is described in the medical journal The Lancet.

“We suggest that our results represent a proof of principle,” Warnke said in a release, noting the patient needs to be followed in the long term before drawing conclusions.

Researchers need to investigate appropriate combinations of biomaterials, growth factors and “blank slate” stem cells needed to build strong, resilient substitutes for bone, said Stan Gronthos, a stem cell expert at the Hanson Institute in Adelaide, Australia.

“A patient who had previously lost his mandible through the result of a destructive tumour can now sit down to chew his first solid meals in nine years … resulting in an improved quality of life for that individual,” Gronthos wrote in a commentary accompanying the study.