myEarthLink
News

Weather  

 

The Weather Channel
Sunny
36° F
New York, NY
Sunny
Hi: 56° / Lo: 44°

Sports   edit

nhl - Scoreboard [hide]

Saturday, February 25, 2017
New Jersey Devils (25-25-11) at
Final
Monday, February 27, 2017
New Jersey Devils (25-25-11) at
Preview
Thursday, March 2, 2017
Washington Capitals (41-13-7) at
Preview

nba - Scoreboard [hide]

Sunday, February 26, 2017
Final
No Games Scheduled
Wednesday, March 1, 2017
Preview

nfl - Scoreboard [hide]

Sunday, January 1, 2017
Final
No Games Scheduled
No Games Scheduled

mlb - Scoreboard [hide]

Sunday, February 26, 2017
Final
Monday, February 27, 2017
Preview
Tuesday, February 28, 2017
Preview
Preview

Market Update  

- By Ryan Vlastelica Dow's 11-day streak of records is longest since 1987 U.S. stocks staged a last-minute rally on Friday, with major indexes turning positive ahead of the closing bell and...
More

MarketWatch

 
Sign In to get personalized news, weather and more at myEarthLink.
 

Printable View

Are face transplants still research, or regular care?
FILE - In this Wednesday, Aug. 24, 2016 file photo, former Mississippi firefighter Patrick Hardison, 42, center, views a video showing progression of his face transplant, during a press conference marking one year after his surgery, at New York University Langone Medical Center in New York. Hardison was disfigured while trying to save people from a house fire in 2001. Is replacing a severely disfigured person's face with one from a dead donor ready to be called regular care, something insurers should cover? Mayo Clinic has raised that question by doing the first U.S. face transplant that's not part of research. (AP Photo - Bebeto Matthews)
By MARILYNN MARCHIONE
From Associated Press
February 17, 2017 2:04 AM EST

Is replacing a severely disfigured person's face with one from a dead donor ready to be called regular care, something insurers should cover? Mayo Clinic has raised that question by doing the first U.S. face transplant that's not part of research.

Faces, hands, wombs and even a penis have been transplanted in recent years. Unlike liver or heart transplants, these novel procedures are not life-saving but life-enhancing.

Who pays for care that can cost $700,000 or more is a growing concern. Ethics and liability issues also may arise when they're done without the oversight of an institutional review board, a hospital panel that ensures research participants' rights are protected.

The group that runs the nation's organ transplant system, the United Network for Organ Sharing, plans a conference to help guide policy.

"It's time to come together and really ask the question, 'Is this going to become a standard of care?'" said Dr. Scott Levin, a University of Pennsylvania surgeon who heads the UNOS panel on this.

He has done several hand transplants and no longer considers them experimental, though insurers won't pay. Worldwide, about 100 hand, face or other, newer body-part transplants have been done, and "that's not a lot of cases" to judge safety and effectiveness for some types, he said.

Andy Sandness' operation last June was Mayo's first face transplant. Worldwide, roughly two dozen have been done, about half of them in the U.S. Four recipients have died.

At Mayo, "we wanted to do it as a clinical program" and felt there was no research question to be answered because the operation uses standard surgical techniques, said the plastic surgeon who led it, Dr. Samir Mardini. Without a transplant, Sandness would have needed 15 other reconstructive procedures and the cost would be 30 to 40 percent higher, Mardini said.

Hospital management and multiple committees reviewed the case, including an ethics panel, a social worker and transplant psychiatrist, to ensure Sandness knew the risks and was giving informed consent.

"It's critically important that he understand what he would be putting himself through," Mardini said.

Sandness' insurance company would not agree in advance to pay; so, a fund from a donor to start a hand and face transplant center at Mayo paid. Talks on paying for after-care are ongoing.

The long-term medical and psychological effects will be studied as part of formal research, even though the operation itself was not, Mardini said.

"I don't particularly agree with the argument that it's not research," said bioethicist Arthur Caplan, who advised New York University on its first face transplant, in 2015.

There's a higher bar to ensuring informed consent for research versus a new therapy, and "questions about competence, experience and even liability are different" when something is called regular care, Caplan said. "In my view it's still highly experimental."

Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.