Clinic setting up first face transplant

Dr Maria Siemionow, of the Cleveland Clinic in Ohio, will study each prospective patient to determine the best candidate for what may be the first operation of its kind.

Dr Siemionow wants to give people disfigured by burns, accidents or other tragedies a chance at a new life. Today's best treatments still leave many with scar-tissue masks that do not look or move like natural skin.

These people already have lost the sense of identity that is linked to the face; the transplant is merely "taking a skin envelope" and slipping their identity inside, according to Dr Siemionow.

However, critics say that the operation is far too risky for something that is not a matter of life or death. They warn of a possible worst-case scenario: a transplanted face being rejected and leaving the patient worse off than before.

Such qualms recently ended face transplant plans in France and the UK, but ultimately, it comes to down to a hospital, doctor and patient willing to try it.

Dr Siemionow, who has been experimenting on animals and since receiving clinical approval to try the operation on people, insisted she was not competing to carry out the first operation.

Dr Joseph Locala, a clinic psychiatrist, will decide whether candidates are mentally fit. "I'm looking for a psychologically strong person. We want people who are going to make it through," he explained.

The Cleveland Clinic's consent form says the surgery is so novel and its risks so unknown that doctors do not think a truly informed consent is possible. The form tells potential patients:

Your face will be removed and replaced with one donated from a cadaver, matched for tissue type, age, sex and skin colour.

Complications could include infections that turn your new face black and require a second transplant or reconstruction with skin grafts.

Drugs to prevent rejection will be needed life-long, and they raise the risk of kidney damage and cancer.