Abstract

Face transplantation is a surgical innovation to manage people with severely interrupted facial function and form. How the public perceive face transplantation and its potential implications for the recipient, donor, and society is unclear. The aim of this study was to understand the public perception of face transplantation, including when it is appropriate, what information is required to feel adequately informed, and which factors influence a person's willingness to donate their face. This was a nationwide survey of participants representative of the GB public. A quantitative analysis was performed. Free-text qualitative responses were coded with thematic content analysis and a narrative analysis was constructed. The survey included 2122 participants. Face transplantation was considered worth the potential risks if it improved an individual's quality of life, gave them a 'normal life', and/or increased their confidence and social interaction. Respondents were worried about the impact face transplantation might have on donor families, especially recipient families adapting to the identity of the donor. Respondents most concerned about the concept of face transplantation were aged at least 55 years (χ2(4) = 38.9, P < 0.001), women (χ2(1) = 19.8, P < 0.001) , and Indian/Asian (χ2(4) = 11.9, P = 0.016). The public perceive emotional and psychological outcomes as equally as important as, or more important than, surgical outcomes when determining the appropriateness of face transplantation. Future research should focus on measuring and describing emotional and psychological outcomes after face transplantation.

Highlights

  • The first face transplantation (FT) was reported in 2005

  • Concern was more often expressed by respondents aged at least 55 years compared with other age groups (v2(4) 1⁄4 38.9, P < 0.001), and this group more often considered FT to be never appropriate (v2(4) 1⁄4 10.4, P 1⁄4 0.034)

  • Respondents perceived FT as appropriate when disfigurements were caused by attack, accident or condition (86 (95 per cent c.i. 84-88) per cent), and least appropriate when caused by self-inflicted injury (45 (4347) per cent), among respondents aged at least 55 years (36 [32-40] per cent), or of Afro-Caribbean (33 (11-55 per cent) or Indian/Asian (19 [6-32] per cent) ethnicity

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Summary

Introduction

The first face transplantation (FT) was reported in 2005. Subsequently, 46 FTs have been performed globally. As FTs become a viable intervention for severely interrupted facial function and form, the scientific literature is tending to focus on technical and quantitative assessments. Face transplantation is a surgical innovation to manage people with severely interrupted facial function and form. How the public perceive face transplantation and its potential implications for the recipient, donor, and society is unclear. Respondents were worried about the impact face transplantation might have on donor families, especially recipient families adapting to the identity of the donor. Conclusion: The public perceive emotional and psychological outcomes as as important as, or more important than, surgical outcomes when determining the appropriateness of face transplantation. Future research should focus on measuring and describing emotional and psychological outcomes after face transplantation

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