Face transplant recipient’s donor face failing

Tissue damage discovered ‘Blanket supplementation will not be effective’

MANCHESTER, NH, Sept 23, (AP): A woman who was severely burned in a domestic violence attack in Vermont is hoping for a second face transplant after doctors recently discovered tissue damage that likely will lead to the loss of her donor face.

Carmen Blandin Tarleton, 51, was burned over 80% of her body when her estranged husband beat her with a baseball bat and doused her body with lye in 2007. Six years ago, she received a face transplant at Brigham and Woman’s Hospital in Boston, where she’s being evaluated for a possible second transplant.

Tarleton, who now lives in Manchester, New Hampshire, told The Boston Globe she has no regrets about the transplant because it dramatically improved her life. She has learned to play the piano and banjo, wrote a memoir and has spoken to many groups about her life. She lost 20 pounds and began walking five miles a week.

“I had such a low quality of life prior to my face transplant. Do I wish it had lasted 10 or 20 years? Of course,” she said.

More than 40 patients worldwide have received face transplants, including 15 in the United States. None of the American patients have lost their donor faces, but last year, a French man whose immune system rejected his donor face eight years after his first transplant underwent a second.

Tarleton’s doctors noted that most transplanted organs have limited life spans. But her situation is a reminder that despite successes in the field, face transplantation is experimental and still a young science with many unanswered questions about benefits versus long-term risks.

“There are so many unknowns and so many new things we are discovering,” said Dr Bohdan Pomahac, director of plastic surgery transplantation at the Brigham and one of Tarleton’s surgeons. Still, he said, “it’s really not realistic to hope faces are going to last (the patient’s) lifetime.”

Dr Brian Gastman, a transplant surgeon at the Cleveland Clinic, which NEW YORK, Sept 23, (RTRS): A large Australian study is debunking the idea that fish oil capsules can lower the odds of premature delivery or raise the chances of late-pregnancy complications.

The study found virtually-identical rates of preterm delivery among 2,734 pregnancies where women were taking fish oil capsules daily and among 2,752 pregnancies where the mothers-to-be were taking vegetable oil capsules with only trace amounts of the n-3 long-chain polyunsaturated fatty acids believed responsible for fish oil’s health benefits.

More babies in the fish oil group were very large for their age than in the control group, but the researchers behind the study said that finding might have been a statistical fluke.

“The bottom line is, blanket supplementation will not be effective. It’s not that simple,” co-author Karen Best, a research fellow at the South Australian Health and Medical Research Institute in North Adelaide told Reuters Health in a telephone interview.

Whether the supplements will help certain groups of women remains an open question. “We need to know who may or not

did the first US face transplant 11 years ago, said more patients are starting to experience chronic rejection. “We all believe every patient will likely need a retransplant” at some point, he said.

Since her transplant in February 2013, Tarleton has had repeated rejection episodes when her new face became swollen and red. Those episodes were successfully treated, but last month, physicians discovered that some blood vessels to her face had narrowed

benefit. That’s the next step,” she said.

The capsules were given out before the 20th week of pregnancy. Babies born before the 35th week were considered preterm; such babies account for most of the newborn deaths and childhood disability seen in preemies.

Previous studies have shown that the less fish consumed during pregnancy, the higher the rate of preterm delivery. The World Health Organization already recommends that pregnant women consume 300 mg of omega-3 fatty acids per day, but women in the US typically consume less than a third of that level.

Best said about 80% of pregnant women take some type of prenatal vitamin product, many of which contain some degree of fish oil.

The study, known as ORIP, had women in the fish oil group taking 900 mg daily of omega-3 fatty acids – contained in three 500-mg fish-oil capsules – until their 34th week of pregnancy. The vegetable oil placebo capsules looked identical. The researchers tried to use a small amount of tuna oil to make the placebo capsules taste the same as the fish oil capsules, but

and closed, causing facial tissue to die. If the damage progresses slowly, she could go on the wait list for another donor face. Under the worst case scenario, the tissue would die quickly, and doctors would have to remove it and reconstruct her original face.

“We all know we are in unchartered waters,” she said. “I would rather not have to go through a catastrophic failure.”

It will take at least a month to evaluate

many volunteers said they could tell which group they were in.

Early preterm delivery occurred in 2.2% of the fish oil pregnancies and 2.0% of the vegetable oil pregnancies, an insignificant difference, the study team reports in The New England Journal of Medicine.

There was a 30% greater chance that a child born to a mother taking fish oil would be very large for gestational age, although the actual number of babies who fell into that category was small. The rates were 5.2% in the fish oil group and 4.0% in the vegetable oil group.

Although the fish oil babies tended to be larger, that did not increase the risk of cesarean-section, the need for oxygen or other complications during delivery, which Best said was good news.

The rates of miscarriage, preeclampsia and diabetes for the mother were comparable in the two groups.

The most significant side effect: women taking the fish oil capsules were more likely to report burping.

Best and her colleagues note that it’s still possible fish oil might benefit the babies of pregnant women who have low levels of omega-3 fatty acids.

Tarleton and reach a decision about a second transplant, doctors said. Aside from the setback with her face, a synthetic cornea transplanted into her left eye recently failed, leaving her almost blind.

“These are not common things to go wrong, but when things go wrong, you have to deal with it,” she said. “l will get back to where I was. How, I don’t know. I will get through this.”