Surgeons poised to perform UK's first ever face and hand transplant

British surgeons are preparing to carry out the UK's first face and hand transplant, it has emerged.

A team at the Royal Free Hospital in north London is currently assessing patients for the procedure, which has only been performed once before in France. Professor Peter Butler, director of surgery and trauma at the Royal Free, has been researching face, and face and hand, transplants for much of his career.

In 2006, he received the go-ahead for the UK's first full face transplant and is now waiting for a suitable donor match. Several patients are also being assessed for a combined hand and face transplant, and are undergoing psychological testing.

It comes as surgical experts at the National Institute for Health and Clinical Excellence (Nice) said "more evidence" was needed on the possible risks and benefits of hand transplant surgery.

In new guidance, it said health professionals should explain the uncertainties and possible risks to all patients considering the operation before they give their consent.

The organisation had been asked by British surgeons to look at issues surrounding the operation, but they have no power to prevent it from happening.

Prof Butler's team is working with surgeons in Birmingham, Austria and the US to share information on proceeding with the transplant. The surgeon, who is head of the UK Facial Transplantation Research Team, said face and hand transplants had long been part of his team's research programme.

"We have a number of patients that we have seen with combined face and hand injuries and a number are potentially going to be done," he said. "Some 60 hand transplants have been carried out worldwide, but more work is needed to ensure the patients are suitable."

Prof Butler said people frequently put their hands up to their face to protect them, meaning they can end up with combined face and hand injuries.

The patients currently being assessed include burns victims, those who have been in a blast, and people who have suffered serious infections.

Prof Butler said the team had been offered "donors or potential donors but no match as yet for our patients" for those needing a face transplant.

"A combined hand and face transplant adds some complexity to the surgery but has benefits for the patient in that it gives them extra functionality. It's not immunologically different or psychologically different (to carrying out a face transplant only].

"Every patient going through the process has unique matching requirements so if a patient with a face and hand requirement matched the donor then that patient would be done."

But he said it was "very difficult to put a timescale on when this will happen".

Worldwide, there have been fewer than ten double hand transplants.Some 11 face transplants have been performed, of which one was a combined hand and face operation.

That recipient, a French national, died from a heart attack caused by a heart problem two months after the surgery. Experts had been trying to tackle an infection that had set in weeks after the transplant.