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NYU Langone Medical Center announces successful total face, scalp transplant

NYU Langone Medical Center held a press conference today to announce the successful completion of the most extensive face transplant to date, which took 26 hours and involved more than 100 staff members.

The recipient was retired volunteer firefighter Patrick Hardison, aged 41, of Senatobia, Mississippi, who experienced extensive facial burns resulting in severe disfigurement of his head, scalp and upper torso in September 2001 during a firefighting accident. The surgery included transplantation of eyelids and blink mechanisms.

Eduardo Rodriguez

“[Hardison’s] surgery sets new standards in facial transplantation and will serve as an amazing learning tool,” Eduardo Rodriguez, MD, DDS, The Helen L. Kimmel professor of reconstructive surgery and chair, Hansjörg Wyss Department of Plastics Surgery at NYU Langone Medical Center, said in a press release. “I am particularly encouraged with the success we have achieved in transplanting [the donor’s] eyelids and blink mechanisms to Patrick. This is a major milestone — one that could lead to preserving vision in future patients.”

“First and foremost, we can transplant the eyelids, especially in Patrick’s case, who had normal vision,” Rodriguez said during the press conference. “Now this provides great hope for individuals who are missing eyelids with vision.”

The procedure involved an amount of tissue “that had not been transplanted before,” Rodriguez reported during the press conference. A similar surgery was attempted 10 years ago in France, but the transplant recipient died in that case, he said.

The 26-hour surgery was divided into three portions: first involved the removal of the donor face and the entire scalp from David P. Rodebaugh, a 26-year-old Brooklyn artist and bicycling enthusiast who had died from injuries sustained in an accident. Rodebaugh was an organ donor, and his family made the decision to donate his face, as well as his organs to other recipients and to research.

The other two portions of the surgery involved removing scar tissue from Hardison and the attachment of the face and scalp onto Hardison.

Hardison waited a year to receive a transplant, as Rodriguez worked with LiveOnNY, the organ recovery organization for the greater New York metropolitan area.

“For Patrick, we needed to find the perfect match,” which included matching hair shade and skin color, Helen Irving, MBA, president and CEO of LiveOnNY, said at the press conference.

Other highlights from the surgery included transplantation of the ears and ear canals, and transplantation of selective bony structures from the donor, including portions of the chin, cheeks and the entire nose.

Advanced use of 3-D modeling, computerized modeling and 3-D printed patient-specific cutting guides based of the recipient’s and donor’s CT scans were used to provide a “snap-fit” of the skeleton, according to the release.

Hardison had undergone 70 surgeries prior to the facial transplant, which preserved his vision, according to Rodriguez.

Hardison is at day 93 post-surgery, according to Rodriguez and will be on immune suppression drugs for the rest of his life. The goal will be to reduce them over time. At 6 months, the surgeons hope to tailor the tissue around the eyelids and lips, where they left plenty of tissue to ensure that it could be sutured and that incision margins would not break down and cause infection.

“He’s doing very well for only day 93,” Rodriguez said about Hardison. As swelling from the surgery decreases, Hardison’s speech will improve. He’s also able to eat regular foods.

Rodriguez estimated the cost of the procedure to be $850,000 to $1 million, which was covered by a grant from Langone. He said it was comparable in cost to a liver transplant. Insurance will provide coverage beyond the 90 days of care Hardison received as part of the transplant, Rodriguez said.

“Now that Patrick has a new face, he was [at first] concerned to look in the mirror,” Rodriguez said at the press conference. “Now that he has a new face, you can see he’s happy with it. He says it’s his face.”

Rodriguez said during the press conference that an ultimate goal from the success of the surgery is to be part of the program to treat wounded soldiers and civilians with injuries that can’t be cured with conventional procedures. – by Bruce Thiel

Reference: www.nyulangone.org

Patrick Hardison, before and after his face transplant.

Source: NYU Langone Medical Center