Face transplant surgeons herald the dawn of “a new era in transplant surgery”

Surgeons for the firefighter Patrick Hardison, who last year underwent the most extensive face transplant in history, have heralded the dawn of a new era in transplant surgery after reporting extremely successful results from the procedure.

“We have entered a new era in transplant surgery,” said Dr Eduardo D Rodriguez, chair Hansjörg Wyss Department of Plastic Surgery at NYU Langone and lead surgeon of the 100-strong team that performed the transplant.

“The work being done, not only in face transplantation, but also in areas like hand, uterine, and penile transplantation, is pushing the boundaries of medicine and surgery and opening up new avenues to restore the lives of people like Patrick. It’s a very exciting time.”

Hardison, a former volunteer firefighter from Mississippi, the US, underwent the face transplant in August 2015, having suffered severe burns to his face and neck during a firefighting attempt 14 years previously.

The surgery, which involved the most extensive soft tissue face transplant in history, was somewhat of a new frontier for the field, meaning it was difficult to predict how well Hardison would recover. However, his recovery has been remarkable, far exceeding what his surgeons expected.

“We are amazed at Pat’s recovery, which has surpassed all of our expectations,” said Rodriguez.

Patrick Hardison's recovery over the past year, from immediately post-surgery (top left) to the start of August 2016 (bottom right). Above: Hardison has his eyes examined as part of a checkup

Patrick Hardison’s recovery over the past year, from immediately post-surgery (top left) to the start of August 2016 (bottom right). Above: Hardison has his eyes examined as part of a checkup

Transplant patients often experience some form of rejection, however Hardison not shown any such signs. His transplanted eye lids and blinking mechanisms have also begun to work fully, ensuring his eyesight has been preserved – by no means guaranteed prior to the surgery.

“Most significant is the lack of a rejection episode. We believe this has much to do with the methodical approach we took in the matching process to ensure that Patrick’s donor provided the most favourable match,” said Rodriguez. “Doing so also has allowed us to reduce the levels of certain medications that Pat takes to prevent rejection.”

The recovery has been so quick that the surgeons were able to commence a number of smaller procedures to complete the process considerably ahead of schedule. This included the removal of feeding and breathing tubes Hardison has relied on since his injury, as well as minor adjustments to his forehead, eyes, lips and chin.

Dr Eduardo Rodriguez, who led the 100-strong team to perform the face transplant. Images courtesy of NYU Langone

Dr Eduardo Rodriguez, who led the 100-strong team to perform the face transplant. Images courtesy of NYU Langone

Rodriguez and his colleagues have published extensive details of the case in a series of academic papers, allowing other surgeons to perform similar procedures in the future, and ultimately enabling face transplants to become a commonplace technique, rather than one worthy of international news coverage.

There have also been some efforts to improve access to such surgeries.

“Since last year’s face transplant, other initiatives have progressed,” explained Helen Irving, president and CEO of LiveOnNY, an organ recovery organisation operating in the greater New York Metropolitan area.

“To date, face transplants in the US have been supported, at least in part, by research funding. The US Department of Defense, in concert with transplant centers, is collaborating with insurance carriers to provide coverage for face transplantation. And here in New York, the state government is considering new legislation to strengthen opportunities for organ donation.”

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