For the first time in the world, a whole-eye and partial face transplant was successfully performed.
A Major Accident
The recipient of the groundbreaking transplant was Aaron James, a 46-year-old man from Arkansas who was shocked with 7,200 volts while working as a lineman in a high-voltage area. The accident took place on June 10, 2021.
Dr. Eduardo Rodrigues, the lead surgeon of the transplant and the director of the face transplant program of NYU Langone, explains that most people do not end up surviving after experiencing this level of injury.
During the accident, a live wire came into contact with the face of James. He had to undergo various reconstructive surgeries as a result. He then ultimately lost his nose, left eye, front teeth, chin, left cheek, and arm over the elbow.
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First Whole Eye, Partial Face Transplant in the World
James explains that when we woke up from a coma that lasted six weeks, experts were already discussing the possibilities of him undergoing a face transplant.
The team at NYU heard of James' case two months after the accident took place. This was when they began consulting his care team at a Texan medical center. The left eye of James needed to be removed because of severe pain. Hence, the NYU team advised that his optic nerve be snipped as closed to the eyeball. This could potentially allow a whole-eye transplant on top of James' planned face transplant.
However, there were some expected risks to couple the transplant. Retina specialist Dr. Vaidehi Dedania from the Department of Ophthalmology at NYU explains that the eye is the brain's extension. A transplant would cover the central nervous system and may lead to risks of deadly inflammation or infection on the brain.
It also remained unclear as to whether the transplanted eye could allow vision. Nevertheless, early tests suggested that the cells that detect light at the back of James' eye could respond to light.
Dr. Dedania explains that the retina of James tells them that it is still capable of seeing light. Scans also suggest that the signal reaches James' visual cortex. However, these incoming signals still cannot be perceived by James, which means that it remains unclear if he will get his vision in this specific eye.
The team also transplanted stem cells in order to plug into the optic nerve. The cells aimed to repair the snipped optic nerve of James, with hopes of restoring its original function.
During the novel procedure, there were two surgical teams that were simultaneously involved. One team was for the donor and the other was for the recipient.
It has been five months since the novel transplant took place. The entire process covered 140 medical providers from NYU and lasted for more than 21 hours on May 27 to 28. During this process, the team transplanted the lower and left upper eyelids, the nose, the upper and lower lips, the left eyebrow, and tissue under the right eye. They also transplanted the cheek, skull, and underlying chin and nasal bones as well as the left eye and optic nerve.
The novel surgery allowed James to stop using feeding and breathing tubes. He is also now able to eat solid foods, taste, and smell once more. He is also undergoing occupational, physical, and speech therapy.
James is also taking immunosuppressive drugs everyday and has not been displaying any rejection signs. While he still cannot open his left eye, he can now squint and tighten surrounding muscles. HIs eyelid is also protecting the eye sufficiently.
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