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Rare double transplant gives man new face and two hands

Doctors say a 22-year-old man, badly burned in a car crash, is recovering well after receiving a rare face and hands transplant.

Mr DiMeo fell asleep at the wheel after working a night shift. His car hit a curb, flipped over and burst into flames.

A passing driver who saw the accident pulled him out of the burning wreckage.

But the young man's injuries were so severe that he was forced to spend months in a medically-induced coma and undergo 20 reconstructive surgeries and multiple skin grafts to treat his extensive third-degree burns.

Once it became clear conventional surgeries could not help him regain full vision or use of his hands, Mr DiMeo's medical team - of more than 140 people - began preparing for the risky transplant.

Doctors amputated both of Mr DiMeo's hands, replacing them mid-forearm and connecting nerves, blood vessels and 21 tendons with hair-thin stitches.

They also transplanted a full face, including the forehead, eyebrows, nose, eyelids, lips, both ears and underlying facial bones.

He is now relearning how to smile, blink, pinch and squeeze.

Rare double transplant

Mr DiMeo said: "They had to amputate the tip of my fingers and my face was burned.

"I had little slits in my eyes, so it was like looking through like a chain-linked fence."

"I knew it would be baby steps all the way. You've got to have a lot of motivation, a lot of patience.

"And you've got to stay strong through everything."

Experts say it appears the surgery at New York University's Langone Health centre was a success, but warn it will take some time to say for sure.

Worldwide, surgeons have completed only 18 face transplants and 35 hand transplants.

But simultaneous face and double hand transplants are extremely rare and have only been tried twice before.

The first attempt was in 2009 on a patient in Paris who died about a month later from complications.

Two years later, Boston doctors tried it again on a woman who was mauled by a chimpanzee, but ultimately had to remove the transplanted hands days later.

Dr Bohdan Pomahac, a surgeon at Boston's Brigham and Women's Hospital who led the second attempt, said: "The fact they could pull it off is phenomenal.

"I know first hand it's incredibly complicated. It's a tremendous success."

Mr DiMeo will be medication for life for the transplants and will need continued rehabilitation to gain sensation and function in his new face and hands.

Doctors had estimated he only had a 6% chance of finding a match compatible with his immune system. They also wanted to find someone with the same gender, skin tone and hand dominance.

And the search for a suitable donor was also scuppered by the COVID-19 pandemic. During New York City's first surge of cases, members of the transplant unit were reassigned to work in coronavirus wards. 

A donor was finally identified in Delaware and the 23-hour procedure was completed a few days later.

Dr Eduardo Rodriguez, who led the medical team of more than 140 people, said: "The possibility of us being successful based on the track record looked slim.

"It's not like someone has done this many times before and we have a kind of a schedule, a recipe to follow."

Since leaving hospital in November, Mr DiMeo has been in intensive rehabilitation, devoting hours daily to physical, occupational and speech therapy.

"Rehab was pretty intense," he said, and involves a lot of "retraining yourself to do stuff on your own again".

During a recent session, he practiced raising his eyebrows, opening and closing his eyes, puckering his mouth, giving a thumbs up and whistling.

Mr DiMeo can feel his new forehead and his hands get cold. He can now dress and feed himself.

He plays pool and with his dog Buster.

Once an avid gym-goer, he is also working out again - and practicing his golf swing.

"You got a new chance at life. You really can't give up," he said.

Reference:: Sky News: 

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