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NYU Langone Hospital in New York announced Wednesday that it completed a face and two-hand transplant on a 22-year-old patient who had been severely injured in a traffic accident, the first successful combined operation of its kind in the world.
The surgery took place on August 12th and lasted about 23 hours, involving a team of more than 140 people, including surgeons, nurses and other staff, the hospital said in a statement.
The receiver, Joe DiMeo, of New Jersey, had suffered third-degree burns over more than 80 percent of his body during a July 2018 motor vehicle accident and, despite undergoing about 20 reconstructive surgeries, still had significant injuries.
Among other things, DiMeo had no fingertips, lips or eyelids, which affected his ability to perform daily activities.
“Joe was an ideal candidate for this procedure; he is extremely motivated and determined to regain the independence he lost after his accident,” Dr. Eduardo D. Rodriguez, who led the transplant, explains in the release.
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DiMeo’s is the fourth face transplant performed under Rodriguez’s direction and the first hand transplant.
According to the hospital, there is evidence that two attempts have been made in the world to transplant the face and hands simultaneously, but both had adverse results, with the death of the patient due to infection in one and no success with the hands in the other.
In this transplant, both the face and hands came from the same donor and the aim was to complete the procedure as quickly as possible to minimize the time the tissues were not receiving blood supply.
Because of the multiple blood transfusions and skin grafts DiMeo had received up to that point, his immune system was very sensitive and his antibody reactive panel (ARP) showed that the percentage of donors his body would reject would be 94 percent.
In other words, the young man had only a 6 percent chance of finding a compatible donor, which, coupled with other factors, “finding the perfect donor for Joe was like finding a needle in a haystack,” Rodriguez says.
Nevertheless, it didn’t take long to succeed, and DiMeo spent only 10 months on the waiting list.
Several cutting-edge technologies were used in preparation for the surgery, such as 3D planning to perfectly align the bones and the plates and screws that were placed in the patient.
“We practiced the surgery almost a dozen times over the course of a year, and in the operating rooms we had equipment that ensured everyone followed the steps exactly so we didn’t skip a beat or get out of sequence. In the end, it went better than I expected,” according to Rodriguez.
Following the operation, DiMeo spent several weeks in NYU Langone, first in intensive care and then in a rehabilitation unit, and once discharged he has continued several hours of recovery therapy per day.
In addition, he has since undergone several follow-up surgeries to improve functional and cosmetic outcomes.
“Everything we do with him is aimed at getting him back to the daily activities he enjoyed before, such as eating and dressing, lifting weights and playing golf,” says April D. O’Connell, a hand and upper extremity rehabilitation specialist.
“This is a once-in-a-lifetime gift, and I hope the family can take some comfort in knowing that part of the donor lives on in me,” DiMeo said in the release.