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Face transplants and other more radical surgeries are likely to follow, doctors say.

Last updated: June 16. 2013 11:35PM - 954 Views

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A Boston hospital is starting the world’s first hand transplant program for children, and doctors say it won’t be long until face transplants and other radical operations to improve appearance and quality of life are offered to kids, too.


The move shows the growing willingness to do transplants to enhance a patient’s life rather than to save it as donated hearts, livers and other organs have done in the past. More than 70 hands and at least 20 faces have been transplanted in adults, and doctors say it’s clear these operations are safe enough to offer to children in certain cases, too.


“We feel that this is justifiable,” Dr. Amir Taghinia said of the pediatric hand program he will lead at Boston Children’s Hospital.


“Children will potentially benefit even more from this procedure than adults” because they regrow nerves more quickly and have more problems from prosthetic hands, he said.


Only one hand transplant is known to have been done in a child — a baby in Malaysia in 2000. Because the donor was a twin who died at birth, her sister did not need to take drugs to prevent rejection.


That’s the main risk in offering children hand transplants — the immune-suppressing drugs carry side effects and may raise the risk of cancer over the long term.


However, one independent expert thinks the gains may be worth it in certain cases.


“We understand so much more about immune suppression” that it’s less of a risk to put children on it, said Dr. Simon Horslen, medical director of the liver and intestine transplant program at Seattle Children’s Hospital. “This is never going to be done as an emergency procedure, so the families will have plenty of opportunity to weigh the options.”


Also, a hand can be removed if rejection occurs, and that would not leave the child worse off than before the transplant, Horslen said.


Several types of kids might be candidates — those born without hands, children who lose them in accidents and children with infections that wind up requiring damaged hands to be amputated.


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