Two facial transplants — one on a Chinese man who had half his face ripped off by a bear — have proved highly successful two years on, opening the way for wider use of the procedure, studies released on Friday reported.

The operations in China and France are among a handful that have pioneered the use of donor tissue to repair severe disfigurement of the face caused by burns, tumours, malformations or trauma, such as car crashes.

Despite some complications, both patients regained most normal physical functions, and enjoyed huge psychological benefits as well. Both studies were published in the British medical journal The Lancet.

A team led by Shuzhong Guo of the Institute of Plastic Surgery at Xijing Hospital in Xian, China report on the case of a 30-year old man, Li Guoxing, who was mauled by a bear in October 2004.

The transplant took place in April 2006 and included the connection of arteries and veins, and repair of the nose, lip and sinuses.

Shortly after the operation, Li told AFP by telephone that he was "very confident" that he would recover.

The farmer, who was attacked while looking for a stray sheep, experienced three acute episodes during which his immune system tried to reject the tissue, but doctors managed to control them with the use of steroids and drugs.

Could be a real solution

"This case suggests that facial transplantation might be an option for restoring a severely disfigured face, and could enable patients to readily integrate themselves back into society," the authors conclude.

In the second case, a 29-year old man in France with a facial tumour called a neurofibroma, caused by a genetic disorder, underwent surgery in January 2007.

The tumour was so massive and hideous that the man could neither eat or speak properly, and was socially isolated.

Like Li, the Frenchman's immune system also flared up, but treatment overcame both rejection episodes. One year after surgery, sensation and motor function had returned to the transplanted tissue.

The patient's psychological recovery was "excellent," said Laurent Lantieri, a professor in the Department of Plastic and Surgery at the Henri Mondor Hospital in Creteil, France.

Reintegrated into society

Less then 13 months after the transplant, the man was working fulltime and considered himself to be fully integrated into society.

"Our case confirms that face transplantation is surgically feasible and effective for the correction of specific disfigurement," Lantieri and his colleagues wrote.

He cautioned, however, that long-term follow up is needed to assess the risks linked to immune rejection of so-called allograft tissue coming from donors, especially concerning life expectancy.

In a comment, also published in The Lancet, two French surgeons, Jean-Michel Dubernaud and Bernard Devauchelle, called for greater co-operation and exchange of data among the pioneering teams working on partial or whole face transplants.

French woman Isabelle Dinoire became the first person in the world to receive a face transplant in 2005.

AFP