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Isabelle Dinoire, Recipient of First Partial Facial Transplant, Dies at 49 Isabelle Dinoire, Recipient of First Partial Facial Transplant, Dies at 49
(about 20 hours later)
Isabelle Dinoire, the Frenchwoman who in 2005 received the world’s first partial facial transplant, paving the way for dozens of other patients to receive this complicated surgery, has died. She was 49.Isabelle Dinoire, the Frenchwoman who in 2005 received the world’s first partial facial transplant, paving the way for dozens of other patients to receive this complicated surgery, has died. She was 49.
In statement released this week, the Amiens-Picardie University Hospital, where the transplant was performed, said that Ms. Dinoire died on April 22 but that it had withheld announcing the death at her family’s request. They had asked for a period of private mourning, the hospital said.In statement released this week, the Amiens-Picardie University Hospital, where the transplant was performed, said that Ms. Dinoire died on April 22 but that it had withheld announcing the death at her family’s request. They had asked for a period of private mourning, the hospital said.
In a separate statement, the hospital, in northern France, suggested that the cause was related to longstanding complications from the operation. In the years after the transplant, Ms. Dinoire had suffered from infections and taken immunosuppressive drugs to keep her body from rejecting the foreign tissue. In a separate statement, the hospital, in northern France, suggested that the cause was related to longstanding complications from the operation. In the years after the transplant, Ms. Dinoire had endured infections and taken immunosuppressive drugs to keep her body from rejecting the foreign tissue.
An assessment this spring revealed a recurrence of a malignant tumor that had been operated on in the summer of 2015. Its return could be “scientifically linked to immunosuppressive therapy,” the hospital said, adding that Ms. Dinoire’s death “perfectly illustrates the challenges of facial transplants.”An assessment this spring revealed a recurrence of a malignant tumor that had been operated on in the summer of 2015. Its return could be “scientifically linked to immunosuppressive therapy,” the hospital said, adding that Ms. Dinoire’s death “perfectly illustrates the challenges of facial transplants.”
As she related in a news conference in Amiens in February 2006, Ms. Dinoire’s ordeal began one day in May 2005 when she came home “after a very disturbing week and with lots of personal worries.’’As she related in a news conference in Amiens in February 2006, Ms. Dinoire’s ordeal began one day in May 2005 when she came home “after a very disturbing week and with lots of personal worries.’’
“I took drugs to forget,” she said.“I took drugs to forget,” she said.
The drugs were sleeping pills. She passed out, she said, and fell against a piece of furniture. The drugs were sleeping pills. She passed out and fell against a piece of furniture.
When she awoke, she said, she was horrified to discover that her pet Labrador had chewed off the bottom half of her face.When she awoke, she said, she was horrified to discover that her pet Labrador had chewed off the bottom half of her face.
“When I woke up, I tried to light a cigarette and didn’t understand why it wouldn’t stay between my lips,” she said. “That’s when I saw the pool of blood and the dog beside it.”“When I woke up, I tried to light a cigarette and didn’t understand why it wouldn’t stay between my lips,” she said. “That’s when I saw the pool of blood and the dog beside it.”
Ms. Dinoire had lost her lips and parts of her chin and nose. She was taken to a local hospital and from there to the Amiens-Picardie hospital, where she was placed under the care of Dr. Bernard Devauchelle.Ms. Dinoire had lost her lips and parts of her chin and nose. She was taken to a local hospital and from there to the Amiens-Picardie hospital, where she was placed under the care of Dr. Bernard Devauchelle.
He saw that the extent of Ms. Dinoire’s disfigurement made her a prime candidate for the transplant surgery and requested that the French Biomedicine Agency, which is in charge of managing organ donors in France, find a suitable donor.He saw that the extent of Ms. Dinoire’s disfigurement made her a prime candidate for the transplant surgery and requested that the French Biomedicine Agency, which is in charge of managing organ donors in France, find a suitable donor.
In July 2005, he spoke with Jean-Michel Dubernard, a doctor who had helped perform the world’s first semi-successful hand transplant in 1998. Dr. Dubernard visited with Ms. Dinoire in August.In July 2005, he spoke with Jean-Michel Dubernard, a doctor who had helped perform the world’s first semi-successful hand transplant in 1998. Dr. Dubernard visited with Ms. Dinoire in August.
Three months later, Dr. Devauchelle and Dr. Dubernard headed up the two teams that performed the surgery, grafting lips, a nose and a chin from a 46-year-old brain-dead donor onto Ms. Dinoire’s face.Three months later, Dr. Devauchelle and Dr. Dubernard headed up the two teams that performed the surgery, grafting lips, a nose and a chin from a 46-year-old brain-dead donor onto Ms. Dinoire’s face.
Waking up 24 hours after the operation, Ms. Dinoire investigated her new face in the mirror, she said. Unable to speak, she wrote a one-word note to her doctors: “Merci.”Waking up 24 hours after the operation, Ms. Dinoire investigated her new face in the mirror, she said. Unable to speak, she wrote a one-word note to her doctors: “Merci.”
Dr. Jean-Paul Meningaud, who heads the reconstructive surgery department at the Henri Mondor Hospital, south of Paris, and who was not involved in Ms. Dinoire’s treatment, told The Associated Press that the operation was “an unquestionable surgical success” and that the medical community learned from her experience. Dr. Jean-Paul Meningaud, who heads the reconstructive surgery department at the Henri Mondor Hospital, south of Paris, and who was not involved in Ms. Dinoire’s treatment, told The Associated Press that the operation was “an unquestionable surgical success” and that the medical community had learned from her experience.
Others were critical of the two doctors, however, saying they had chosen the glory of a groundbreaking medical operation over the alternative of reconstructive surgery, which the critics said would have been safer and in the best interests of their patient. A member of the regulatory body that had approved the surgery called for the surgeons’ conduct to be investigated. Others were critical of the two doctors, saying they had chosen the glory of a groundbreaking medical operation over the alternative of reconstructive surgery, which the critics said would have been safer and in the best interests of their patient. A member of the regulatory body that had approved the surgery called for the surgeons’ conduct to be investigated.
Dr. Dubernard had faced similar criticism before. The patient to whom he had helped give a new hand later had it amputated after deciding not to follow the requisite antirejection therapy.Dr. Dubernard had faced similar criticism before. The patient to whom he had helped give a new hand later had it amputated after deciding not to follow the requisite antirejection therapy.
In Ms. Dinoire’s case, Dr. Dubernard argued that the injuries “would have been extremely difficult, if not impossible, to repair with classic surgery.” He and Dr. Devauchelle warned her of the risk, they said, advising her that there was only a 33 percent chance that the transplant would be a success.In Ms. Dinoire’s case, Dr. Dubernard argued that the injuries “would have been extremely difficult, if not impossible, to repair with classic surgery.” He and Dr. Devauchelle warned her of the risk, they said, advising her that there was only a 33 percent chance that the transplant would be a success.
According to Amiens-Picardie University Hospital, 36 facial transplants have been performed worldwide since Ms. Dinoire’s operation, and six of the patients who have undergone the surgery have died.According to Amiens-Picardie University Hospital, 36 facial transplants have been performed worldwide since Ms. Dinoire’s operation, and six of the patients who have undergone the surgery have died.
“The majority of patients, despite potent immunosuppressive therapy, develop acute rejection reactions of the skin,” the hospital statement said, adding that patients often suffer infectious complications and tumors, as well as side effects like diabetes, kidney failure and hypertension.“The majority of patients, despite potent immunosuppressive therapy, develop acute rejection reactions of the skin,” the hospital statement said, adding that patients often suffer infectious complications and tumors, as well as side effects like diabetes, kidney failure and hypertension.
Little is known of Ms. Dinoire’s earlier life; she was known to be extremely private. But the hospital said she had worked as a seamstress before the surgery, was divorced and had two adult daughters. There was no immediate information on survivors. Little is known of Ms. Dinoire’s personal history — she insisted on her privacy — but the hospital said she had worked as a seamstress before the surgery, was divorced and had two adult daughters. There was no immediate information on survivors.
Ms. Dinoire had refused to be identified immediately after the surgery. Nonetheless, her doctors said at the time that the attention she was receiving from the news media — including reports speculating about whether she had tried to commit suicide — was complicating her recovery and having psychological effects.Ms. Dinoire had refused to be identified immediately after the surgery. Nonetheless, her doctors said at the time that the attention she was receiving from the news media — including reports speculating about whether she had tried to commit suicide — was complicating her recovery and having psychological effects.
A doctor who had reviewed some of Ms. Dinoire’s medical records soon after the surgery told The New York Times in an interview that her psychological problems would have made him reluctant to perform the surgery himself.A doctor who had reviewed some of Ms. Dinoire’s medical records soon after the surgery told The New York Times in an interview that her psychological problems would have made him reluctant to perform the surgery himself.
But Ms. Dinoire, although she rarely spoke publicly, expressed gratitude for the operation. In a 2012 interview, she told the BBC that she had gotten over the humiliation of the attention she received from passers-by.But Ms. Dinoire, although she rarely spoke publicly, expressed gratitude for the operation. In a 2012 interview, she told the BBC that she had gotten over the humiliation of the attention she received from passers-by.
“With time I have got used to my own face,” she said. “This is what I look like, what I am like, who I am. If people stare at me insistently, I don’t care anymore. I just stare back!”“With time I have got used to my own face,” she said. “This is what I look like, what I am like, who I am. If people stare at me insistently, I don’t care anymore. I just stare back!”