AIIMS Delhi may carry out first face transplant, offer hope, dignity to patients with severe deformities

There is a new ray of hope for patients in India who struggle with severe facial deformities and get no respite even after undergoing as many as 10 to 12 reconstructive surgeries, as the All India Institute of Medical Sciences (AIIMS) Delhi has launched the first face transplant programme and is aiming to perform the first such surgery in the country within a year, subject to regulatory clearances.

A face transplant involves replacing a part of or the entire face with tissue from a deceased donor. A face transplant helps restore essential functions like speech, breathing, eating, eyelid closure, and facial expression in patients for whom conventional reconstruction cannot provide relief.

Such patients also struggle with severe social stigma and resultant isolation.

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“Many patients suffer devastating facial deformities due to acid attacks, gunshot injuries, and burns. Identifying the right candidate for the transplant and counselling him or her is essential. Unmotivated or unstable patients—those with active infections or cancers—are not suitable. That said, face transplantation is no longer experimental, it is the need of the hour,” said Dr Maneesh Singhal, head of plastic, reconstructive, and burns surgery at AIIMS.

Surgery lasts up to 16 hours

The surgery can last 14 to 16 hours and requires meticulous reconnection of blood vessels and nerves under a microscope. Even if the transplant is successful, patients have to take immunosuppressive drugs to prevent rejection and need close monitoring for complications.

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Dr Dipankar Bhowmick, head of nephrology at AIIMS, said the institute has the necessary systems in place to carry out such transplants. “Immunosuppression plays a critical role, and all infrastructure and facilities are available at AIIMS. I am excited and will provide the best possible support for this initiative,” he said.

Donor matching a crucial challenge

Unlike other organ transplants, a face transplant also requires visible compatibility, and the donor and recipient must be of the same sex, besides having similar skin tones.

The transplant will involve a multidisciplinary team of surgeons, transplant physicians, nephrologists, anaesthesiologists, psychiatrists, and rehabilitation experts.

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International expert Dr Indranil Sinha of Brigham and Women’s Hospital, Harvard Medical School, said the skill set and infrastructure at AIIMS are on par with international standards and pledged his support to the programme.

The burns and plastic surgery department at AIIMS performs over 8,000 procedures each year and handles numerous acid-attack survivors and severe trauma patients. For many patients, reconstruction merely restores limited function and appearance.

Globally, face transplants are performed in only a handful of countries, and India is poised to join the select group.