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Facing the future

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The very idea is so shocking that it's hard to believe it will actually happen soon. Heart transplants have been performed for more than 30 years. Kidneys, bone marrow, livers, lungs, and pancreas transplants are now almost routine. So far, nearly two dozen hands have been successfully transplanted.

And now, what has previously existed only in the minds of science fiction writers will take place in a real-life operating room: the face of a deceased person will be surgically removed and transplanted to the skull of a patient whose face has been severely disfigured in a fire or accident.

For 20 years, medical researchers in Europe, Asia and the United States have intensely studied the procedure. In Britain and France, the risks involved - medical, legal and ethical - have been deemed too complex to proceed.

But medical authorities in the US have concurred that the surgical transplantation of a full human face is now technically possible. What's more, two highly respected medical institutions, only a few hundred kilometres apart from each other, have been given clearance to perform the controversial medical procedure.

Doctors at the Cleveland Clinic Foundation, in Ohio, and the Medical School at the University of Louisville in Kentucky are now both quietly screening possible candidates to receive the world's first face transplant.

Such an operation, when finally scheduled, is expected to take from 12 to 16 hours. That's the estimated time it will probably take for a team of expert surgeons and medical technicians to disconnect the hundreds of tiny veins, arteries, tissues and muscles that connect the human face to the skull of a cadaver ... and then repeat the process in reverse, restitching the face - from hairline to jaw line, and from ear to ear, including the mouth, lips, nose, eyebrows and eye lids - to the living patient's skull.

A recent New York Times report suggests that Maria Siemionow of the Cleveland Clinic will likely be the doctor to lead a team of medical experts in performing the world's first face transplant. The Polish-born, US-trained surgeon is the director of plastic surgery research at the hospital. At age 55, Dr Siemionow has been involved in transplant surgery for about 30 years and has been researching the possibility of face transplants for half that period.

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