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MANCHESTER – A woman who was severely burned during a domestic violence attack in Vermont is hoping for a second facial transplant after doctors have recently uncovered tissue lesions likely to result in the loss of her face's face giver.
Carmen Blandin Tarleton, 51, a former resident of Thetford and Fairlee, was burned to over 80% of her body when her ex-husband beat her with a baseball bat and sprayed her with laundry in 2007. Six years ago, she received a facial transplant at Brigham and the Woman's Hospital in Boston, where she is currently being evaluated for a second transplant.
Tarleton, who now lives in Manchester, N.H., said The globe of Boston she does not regret the transplant because she has made a big difference in her life. She learned to play piano and banjo, wrote a memoir and talked about her life to many groups. She lost 20 pounds and started walking 5 miles a week.
"My quality of life was so low before the face transplant. Would I have liked it to last 10 or 20 years? Of course, she says.
More than 40 patients worldwide have received a facial transplant, including 15 in the United States. No American patient has lost the face of his donor, but last year, a Frenchman whose immune system had rejected the face of his donor eight years after the first transplant suffered a second.
Tarleton's physicians noted that most transplanted organs have a limited life span. But her situation reminds us that, despite the successes on the ground, facial grafting is experimental and is still a young science with many unanswered questions about the benefits versus long-term risks.
"We are seeing so many unknowns and so many new things," said Dr. Bohdan Pomahac, director of plastic surgery transplant at Brigham and one of Tarleton surgeons. However, he added, "it is really unrealistic to expect faces to be lifelong (patient)."
Dr. Brian Gastman, a transplant surgeon at the Cleveland Clinic, who performed the first facial transplant in the United States 11 years ago, said that more and more patients were starting to experience chronic rejection. "We all think that every patient will probably need a retransplantation" at some point, he said.
Since his transplant in February 2013, Tarleton has had several episodes of rejection when his new face became swollen and red.
These episodes were successfully treated, but last month, doctors discovered that some of the blood vessels in the face had shrunk and closed, causing the death of facial tissue. If the damage progresses slowly, it could be listed on the waiting list of another donor face. In the worst case, the tissue would die quickly and doctors should remove it and rebuild its original face.
"We all know that we are in unexplored waters," she said. "I would rather not have to suffer a catastrophic failure."
It will take at least a month to evaluate Tarleton and make a decision on a second transplant, doctors said. In addition to the back of her face, a synthetic cornea transplanted into her left eye has recently failed, leaving her almost blind.
"It's not common things that go wrong, but when things go wrong, you have to deal with them," she said. "I will come back to where I was. How, I do not know. I will go through that. "
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