Although he has survived the critical post-surgery period, China's first face transplant patient Li Guoxing has to wait another two months to know if the operation has been a success.

Li, a 30-year old whose face was disfigured by 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 patient last year.

Li, from Lisu ethnic group, 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, but enraged the animal. It pounced on him and mauled his face.

The attack ended when Li's fellow villagers arrived on 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 he remained disfigured as he could not afford plastic surgery.

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 Natural Conservancy (TNC), a leading US-based non-profit 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 learning that 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.

Dream comes true

On March 9, Li left for Xi'an, together with an 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 brain-dead by the hospital.

During the 14-hour procedure 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, though doctors may make further surgical modifications to make the face more natural, said Guo Shuzhong, director of the hospital's plastic surgery department.

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.

(China Daily April 24, 2006)