Face transplant gives ex-firefighter his life back

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Patrick Hardison before the transplant and a year later(Credit: NYU Langone Medical Center)

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One year ago, Patrick Hardison underwent the world's most extensive face transplant at NYU Langone Medical Center in New York. The severely-burned Mississippi firefighter had lost most his facial and head features in the line of duty in 2001, but 15 years later the change is nothing short of dramatic. His doctors call his recovery "unprecedented" and holds promise for the future of similarly injured patients.

In September 2001, Hardison and three other firefighters were conducting a rescue search during a house fire in Mississippi when the ceiling caved in. Though he survived by holding his breath to protect his lungs, Hardison suffered severe third degree burns the his face, head, neck, and upper torso that destroyed his ears, lips, most of his nose, and almost all of his eyelid tissue – leaving his face, even with the best medical efforts, a mass of scar tissue.

In 2015, after years of treatment in hospital and over 70 procedures, a team of 100 surgeons and medical professionals led by Eduardo D Rodriguez, the chair of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone, performed a face transplant on Hardison that was more complex than any previously attempted.

Because of the extent of Hardison's injuries, the team had no framework to build on, so they relied on advanced 3D modeling and 3D-printed cutting guides to match together Hardison and the donor organs.

The initial results were already dramatic, but after a year of recovery and several follow-up operations to adjust Hardison's new eyelids and lips; removal of his abdominal feeding tube and tracheal breathing tube; revisions to his forehead, eyes, lips, chin, and ears, he is now able to engage in previously impossible activities, such as swimming and driving.

"We are amazed at Pat's recovery, which has surpassed all of our expectations," says Rodriguez. "Most significant is the lack of a rejection episode. We believe this has much to do with the methodical approach we took in the matching process to ensure that Patrick's donor provided the most favorable match. Doing so also has allowed us to reduce the levels of certain medications that Pat takes to prevent rejection."

According to Rodriquez, Hardison now has normally functioning eyelids, which not only improves his appearance, but has also saved his eyesight by allowing him to blink to moisten and cleanse his eyes. Rodriguez calls this a "game changer" for reconstructive surgery.

In addition, the use of selective facial bone structure, along with the chin of the donor, gave Hardison natural bone marrow stem cells to help the transplanted face heal after surgery.

"Pat has been incredibly compliant with his postsurgical regimen, and that has allowed us to expedite his surgical schedule," says Rodriguez. "He is extremely committed to daily exercise, taking his medications and meeting with his physicians regularly. All of this has put him way ahead of schedule in terms of getting to the optimal level of recovery and appearance."

Hardison says that he's now ready to meet the family of David Rodebaugh, the 26-year old Brooklyn artist and cycling enthusiast from Ohio, who donated his face and other organs after his death in a cycling accident.

"The surgery has truly given me back my life," says Hardison. "I go about my day just like everyone else. It's allowed me to do things with my family that I had not been able to do. I can't tell you what a sense of freedom it is to even drive my kids to school. We recently went on a family vacation to Disney World, and I swam in the pool with them — something I hadn't done in 15 years.

"There are no more stares, no more frightened children running away from me. I'm pretty much just a normal guy. Now, I want to help others to pursue this type of surgery, especially fellow firefighters and members of the armed services. There definitely is hope."

According to Helen Irving, president and CEO of LiveOnNY, the organ recovery organization for the greater New York metropolitan area, New York State is considering new legislation to encourage organ donation, and the US Defense Department has provided research funding and other support in the reconstructive surgery field.

"We have entered a new era in transplant surgery," says Rodriguez. "The work being done, not only in face transplantation, but also in areas like hand, uterine and penile transplantation, is pushing the boundaries of medicine and surgery and opening up new avenues to restore the lives of people like Patrick. It's a very exciting time."

Hardison's operation is detailed in a number of papers published in Plastic and Reconstructive Surgery.

The video below shows Patrick Hardison today.

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