Rare near-total face transplant helps accident victim

Nearly a full six years after the first successful full face transplant in the U.S., the Cleveland Clinic announced this week they’ve successfully replaced nearly the entire face of the survivor of traumatic injury in a traffic accident.

The middle-aged man, who has asked to remain anonymous, underwent the 24.5-hour surgery in late September, a statement by the Cleveland Clinic reports. The surgery consisted of nearly 90 percent of the patient’s face, including two-thirds of his scalp, his forehead, eyelids, eye sockets, nose and upper jaw. His medical team reports that he’s recovering well, breathing without a tube and readying to eat soon. Doctors continue to monitor him for signs of tissue rejection.

“The surgery went very well, thanks to the multidisciplinary team of physicians and clinicians,” says Dr. Maria Siemionow, co-leader of the physician team, during an interview with health enews. Dr. Siemionow led a similar physician team for the first U.S. face transplant in 2008. “The patient had severe complications from a motor vehicle accident,” she says.

She said previous reconstruction attempts were unsuccessful, making the patient a good candidate for the landmark surgery.

“This is an important success and recognition for the importance of tissue donation,” Dr. Siemionow says. “Our face is so important to our sense of identity. We learn more with each procedure.”

She says the U.S. Department of Defense is particularly interested in developing this standard of care for wounded soldiers. This face transplant was supported by the department’s Armed Forces Institute of Regenerative Medicine I (AFIRM I) grant program, which supports advances in regenerative medicine to improve the treatment of U.S. service members wounded in battle. This is only the third such surgery in the U.S.

“For many wounded soldiers, the face and hands are the only body surfaces exposed, not under layers of protective clothing and armor,” Dr. Siemionow says. “So program is very important for wounded warriors.”

“There have only been about 30 face transplant procedures performed world-wide,” says Dr. Marek Rudnicki, surgeon at Advocate Illinois Masonic Medical Center in Chicago. “The cases in the U.S. have been the first well-documented procedures involving more than 80 percent of the patients’ faces. This is, again, an amazing achievement.”

Dr. Rudnicki says those who suffer facial trauma often experience not only physical, but emotional and psychological pain that comes along with the injury. He and Dr. Siemionow agree that such transplants aren’t simply aesthetic, but functional, allowing the patient to eat, smile, smell and be socially accepted.

Little detail was released on the patient out of respect for his right to privacy. However, the media release announcing the procedure included a statement from him, expressing his support for organ and tissue donation:

“I am grateful beyond words to the donor and his family for their amazing gift,” he says. “I learned through this process that it’s so important that we raise awareness about organ and tissue donation. Your driver’s license donor card is not enough; please talk to your loved ones about your further donation wishes.”