This is quite a remarkable achievement in that the patient, a volunteer fire-fighter aged 41, had suffered severe burns across his entire face including the loss of eyelids, ears, lips, most of his nose and the entire scalp during a rescue search in a burning home in 2010. He had had some 80 reconstructive procedures on his face since the injury and all this reconstruction had to be excised at the time of the transplant. Dr. Rodriquez, a surgeon at NYU Langone, with a team of some 100 colleagues and assistants, found a suitable donor and successfully carried out the donor operation and the transplant in adjoining theaters. However, what is unusual in this particular case, among the 37 cases of facial transplant carried out worldwide, was the use of 3-D modelling to enable a good fit with the patient’s skeleton as some of the skeleton of the patients face had to be replaced or augmented in addition to the soft tissues. He still had his eyesight intact and so they were able to transplant the face with eyelids and relevant muscles and both ears in April 2014. This was indeed a tour de force. At the time of the report there had been no episodes of acute rejection and the functional result is impressive.
Dr Rodriquez is a graduate of the Medical College of Virginia and received his plastic surgeon training at the Johns Hopkins before moving to NYU Langone. He had performed a face transplant earlier in Baltimore before his move to NYU. The cost of the procedure and all related care was estimated to be around $1 million dollars. This is definitely a further step forward in establishing facial transplantation as an acceptable procedure in the right centre, but it remains an experimental procedure.
Bulletin of the American College of Surgeons, April 2016.