Although he has lived through a 24-hour post-operation critical period, Li Guoxing, China's first face transplant patient, still has to wait two months to know if the operation has been a success.
 
Li, a 30-year old whose face had been disfigured from an attack by a bear, received a partial face transplant operation in a northwestern Chinese hospital on April 14, the second of its kind following a French female patient last year.

However, Li's operation would not have been possible without efforts by a number of people, including officials, volunteers and doctors. 

Nightmare encounter with black bear 

A man of Chinese Lisu ethnic minority, Li lives in a mountainous village in China's southwestern province of Yunnan. In 1997, the local government of Lanping County, Li's hometown, began to promote the protection of wild animals, which included the black bear.

One and a half years ago, Li was looking for his lost sheep on a mountain near his village when he saw a black bear eating it. Without thinking, Li picked up a wooden stick to try to drive the bear away, only to enrage the animal. The bear pounced on him and mauled his face.

The bear's attack ended when Li's fellow villagers arrived at the scene, but the right side of his face and nose were almost lost. Li was immediately sent to a local hospital for treatment. His life was saved but the disfigurement remained as he could not afford plastic surgery.

International organization brings hope for Li

After the attack, Li's life changed. He was afraid of being seen by people outside of his family and he could not continue his part-time jobs.

"The primary school where his teenage daughter studies did not even allow him to pick her up as teachers feared that his scarred face may scare the kids at school," Qiao Xiurong, a teacher at the school, said.

The Natural Conservancy (TNC), a leading US-based nonprofit organization dedicated to preserving the diversity of life on earth, learnt of Li's case.

"At first, we really were not sure whether we could help him," said Zhou Dequn, who works on the TNC project in Lijiang in Yunnan. The project aims to study the living conditions of black bears in Asia and also tries to offer help to those who are injured by wild animals.

At the end of 2005, after knowing that the Xijing Hospital in Xi'an, capital of northwest China's Shaanxi Province, had successfully performed a facial skin transplant operation on a rabbit, we contacted the hospital with the help of a local medical college in Yunnan and asked if it could perform an operation on Li, Zhou said.

Guo Shuzhong, director of the hospital's plastic surgery department, remembered the deep impression left by seeing Li when he came to Yunnan to give his diagnosis.

"He (Li) always walked along the walls, trying to hide his disfigured face from others," said Guo.

The hospital finally decided to carry out the operation free of charge.

Dream of new face becomes true

On March 9, Li left for Xi'an, together with TNC's Zhou and his colleagues, and Qiao Xiurong who is Li's interpreter as he cannot speak standard Chinese.

Li waited nearly a month in Xi'an before the hospital found a male donor for him. The donor had been declared a brain-dead patient by the hospital.

Under an agreement signed between the Xijing Hospital and the relatives of the donor before the operation, no details about the donor's identity were allowed to be revealed as such an operation involves ethic and moral issues for the Chinese people.

During the 14-hour procedure that ended on April 14, Li Guoxing was given a new cheek, upper lip, nose and an eyebrow. Doctors at the hospital claim that the operation was even more complex than the world's first such operation on 38-year-old Isabelle Dinoire, whose lips and nose were ripped off by a dog last November.

The first thing that Li did after regaining consciousness was to ask for a mirror, but doctors refused his request initially as they worried that he might be too emotional when seeing his new face.

But doctors later said Li had seen his new face in the mirror and was satisfied with the operation.

As the donor was much more pale-skinned than Li, Li's new face will resemble neither that of the donor nor his original one, but we may make further surgical modifications to make Li's new face more natural, Guo said.

The final success of the transplant will depend on whether Li can get through an acute rejection period of one or two months, but judging by Li's recovery so far, there should be few problems, according to Guo.

"Perhaps Li's wife needs some time to become familiar with Li's new face," Guo said.

(Xinhua News Agency April 24, 2006)