Abstract

In 1997 when Americans first saw the John Travolta and Nicholas Cage movie entitled "Face Off," most assumed it was firmly rooted in the world of science fiction. In this movie an FBI agent played by Travolta, in order to infiltrate the inner circle of a nepharious criminal played by Cage, literally changes identities with him by having their faces surgically removed and cross transplanted one to the other. Even though this may seem somewhat far fetched and certainly in the realm of fiction, there have been, since 1992, several centers around the world investigating the possibility of composite tissue allotransplantation (CTA). The largest experience with CTA is in hand transplantation and approximately twenty have been reported world-wide. Two have been done in the United States at the University of Louisville in Louisville, KY. The functional results of hand transplantation have been reported as being equivalent to replantation at similar levels. There have also been reports of transplantation of vascularized nerve grafts, various joints, the larynx, the tongue, the abdominal wall and, of course, most recently a partial face transplantation in France. There are at least two institutions in the United States that have obtained IRB approval to proceed with identification of an appropriate recipient and an appropriate donor to perform a facial transplantation. These are the University of Louisville, previously mentioned, and the Cleveland Clinic.