Firefighter gets most comprehensive face transplant yet

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Surgeons at New York University's (NYU) Langone Medical Center have replaced the entire face of a patient in the what is claimed to be the most extensive face transplant ever carried out(Credit: NYU Langone Medical Center)

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In what is being touted as the most complex and complete face transplant ever performed, a crew of medicos at New York University's (NYU) Langone Medical Center has replaced the entire face of 41-year-old Patrick Hardison, a volunteer firefighter who suffered catastrophic burns while on duty in 2001. The team replaced Patrick's scalp, ears and ear canals, parts of bone in the chin and cheeks, and his entire nose. He also received new eyelids and the muscles that control them.

With a team of more than 100 physicians, nurses, technical and support staff led by Dr. Eduardo D. Rodriguez, chair of the Hansjörg Wyss Department of Plastic Surgery, the operation took some 26 straight hours of surgery to perform. The marathon operation took more than a year of preparation and was carried out only after Patrick had suffered through more than 70 previous procedures.

"When I met Patrick and heard his story, I knew that I had to do all I could to help him – and every member of my team felt the same way," said Dr. Rodriguez. "His surgery sets new standards in facial transplantation and will serve as an amazing learning tool. We could not have helped Patrick without amazing teamwork."

Whilst fighting a fire in in Mississippi in September 2001, Patrick had begun a rescue search into a burning home when the roof collapsed on him. He suffered massive and horrific burns across all of his face, head, neck, and upper torso. So intense was the heat that he also lost his eyelids, ears, lips, hair, eyebrows, and just about his entire nose.

Not quite as great a loss of bone as other recent face transplants, Patrick's complete loss of all features, however, meant that doctors had no framework on which to build, making this transplant that much more difficult and comprehensive.

What followed on from the accident for Patrick was years of hospital treatment and more than 70 separate operations intended to help restore at least some of his lost skin. Finally, after standard medical procedures could do little more for him, Patrick was referred to Dr. Rodriguez, whose experience is at the forefront of facial reconstruction surgery.

To help comprehensively support Patrick and his surgery, Dr. Rodriguez was engaged by NYU Langone to lead a surgery department, develop the Face Transplant Program, and prepare a team of medical specialists to help him perform the groundbreaking operation.

The operation also required the input of advanced 3D computer modeling, and 3D-printed cutting guides designed from Patrick's and the donor's CT scans, in order to exactly match and fit the supporting skeleton of bones.

The donor was 26-year-old David P. Rodebaugh, a Brooklyn artist and cycling enthusiast from Ohio. He died as the result of injuries sustained in a cycling accident on a Brooklyn street in July and was a registered organ donor. In addition to his face being donated to Patrick, his heart, liver and kidneys were also donated to other recipients, and to research.

It has now been some three months since the surgery, and Patrick is reported to be doing well and is rapidly becoming able to perform normal daily routines. He will need to remain on anti-rejection medication for the rest of his life to prevent transplant rejection, as well as receive continuous and on-going rehabilitation therapy to recover his strength and improve his speech.

"I am deeply grateful to my donor and his family," said Patrick. "Even though I did not know who they would be, I prayed for them every day, knowing the difficult decision they would have to make in order to help me. I hope they see in me the goodness of their decision. I also want to thank Dr. Rodriguez and his amazing team. They have given me more than a new face. They have given me a new life."

The video below from NYU Langone outlines Patrick's case.

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