Chimp victim moved to Cleveland Clinic

February 19, 2009 2:53:40 PM PST
A Connecticut woman grievously wounded in the face and hands this week by a rampaging chimpanzee has been transferred to the Cleveland Clinic, which two months ago performed the nation's first successful face transplant. Charla Nash was transferred from Stamford Hospital to the Cleveland facility on Thursday, three days after she was mauled by a 200-pound chimp owned by her friend. Spokeswoman Eileen Sheil said she was being seen by a head and neck surgeon and likely will be treated through a team approach involving many specialists, Sheil said.

"I don't know at this point" if a face transplant will be considered, Sheil said. "Priority one is to stabilize her."

The attack left the 55-year-old Stamford woman with severe wounds to her hands and face, requiring four teams of surgeons to work more than seven hours Monday to stabilize her. She left Connecticut in critical condition, although she improved slightly since her operation, officials said.

Nash's transfer to Cleveland likely is because of the clinic's expertise in facial reconstruction - not because doctors are considering a transplant right away, said a leading surgeon with another hospital.

"This is a difficult time for the patient and she will need to adjust to it first. All the other options should be discussed first" before something as radical and risky as a transplant is considered, said Dr. Bohdan Pomahac, a reconstructive surgeon at Harvard-affiliated Brigham and Women's Hospital in Boston.

"Often things sort of sound worse than they really are," he said. If any of Nash's face was salvaged, "a lot of the tissues can be returned to where they came from," or repaired with traditional skin grafts or flaps, he said.

In December, surgeons at the Cleveland Clinic completed the nation's first face transplant on an unidentified woman who suffered a traumatic injury several years ago. The injury left her with no nose, palate, or way to eat or breathe normally.

In a 22-hour procedure, 80 percent of her face was replaced with bone, muscles, nerves, skin and blood vessels from another woman who had just died.

It was the fourth partial face transplant in the world, though the others were not as extensive. Nor were any done as emergency operations, said Dr. W.P. Andrew Lee, chief of plastic surgery at the University of Pittsburgh.

"It would be unusual" to perform one so soon for Nash, he said.

To consider it, doctors must make sure she is medically stable, that alternatives have been carefully considered, and that she truly had given informed consent, because a transplant requires taking anti-rejection drugs lifelong, Lee said.

That could conceivably be done in a matter of weeks, but "to find a suitable donor with matching skin color and size and other features, that's a practical limitation," he said.

Cleveland doctors have said it took several months to find a suitable donor for the face transplant Dr. Maria Siemionow performed in December. Siemionow is out of the country at a conference.

The chimp in Monday's attack, a 14-year-old named Travis, was shot and killed by police. Authorities have not decided whether they will file charges against his owner.