The electrocuted man underwent the first face transplant, including an eye

(HealthDay News) — An Arkansas man was left paralyzed after being electrocuted in the face. He has successfully received the world’s first complete eye transplant and partial face transplant.

A Surgery at 9 p.m In May, a surgical team at NYU Langone Health transplanted an entire left eye and part of a face from a donor. To Aaron James, a 46-year-old Army veteran from Arkansas A survivor of a high-voltage workplace accident. “I am very grateful to the donor and his family, People who gave me a second chance at life during a time of great difficulty,” James said in an NYU Langone news release.

I hope the family finds comfort in knowing that a part of the donor lives on with me. Our hope is that my story will be an inspiration to those facing serious facial and eye injuries,” added James.

It is not yet known whether James will regain vision in his left eye, but doctors say he has shown significant signs of health in the months since the operation. This involves restoring blood flow to the retina, which receives light at the back of the eye and sends images to the brain.

“The fact that we have achieved the first complete eye transplant with a face is a tremendous achievement, something many people thought was impossible for a long time,” said Dr. Eduardo Rodriguez, director of the Face Transplant Program at NYU Langone. “We’ve taken a big step forward and paved the way for the next chapter in restoring vision.” This is the fifth face transplant performed under Rodriguez and the first full eye transplant ever, doctors said.

James survived a 7,200 volt electric shock in June 2021 when he accidentally touched a power line while working as a power line technician. He lives in Hot Springs, Arkansas. He underwent several reconstructive surgeries, but had extensive injuries, including the loss of his left eye, his entire nose and lips, his front teeth, and even his cheekbone. Doctors at NYU Langone consulted with specialists at a medical center in Texas two months after James’ injury during the initial stages of reconstruction.

For example, while Texas surgeons had to remove James’ left eye due to severe pain, NYU surgeons recommended cutting the optic nerve as close to the eyeball as possible.

This would preserve additional nerve length and increase future reconstructive options. They discussed the possibility of a face transplant with James next year and made an initial estimate for a transplant in June 2022. James and his doctors decided to proceed with the face transplant. “Since James needed a face transplant and was taking immunosuppressive drugs anyway, the risk-benefit ratio of an eye transplant was very low,” Rodriguez pointed out. James was officially listed as a recipient in February by the United Network for Organ Sharing, a private nonprofit organization that manages the U.S. organ transplant system. Three months later, in May, a potential donor was identified at another hospital in New York City.

“The hero donor is a young man in his 30s who comes from a family that strongly supports organ donation,” said Leonard Achan, president and CEO of LiveOnNY, a New York organ procurement organization. “He, with the support of his family, generously donated the tissue that led to this successful face and eye transplant, but he also saved three people between the ages of 20 and 70, donating their kidneys, liver and pancreas.”

NYU Langone reported that the May 27 transplant involved a team of more than 140 surgeons, nurses and other healthcare professionals. Two highly skilled teams operated simultaneously on both the donor and the patient, following a carefully planned schedule. Corneal transplantation is common in the human eye, but whole eye transplantation to restore vision remains elusive due to the complexity of the eye.

For an eye transplant to be successful, the eye’s connection to the brain via the optic nerve must be successfully restored, blood flow to the retina must be restored, and the recipient’s body must be immunosuppressed to avoid rejection. Rodriguez and his team decided to combine the donor eye with the donor’s stem cells, obtained from his bone marrow, in hopes of improving nerve regeneration. Stem cells were injected into James’ optic nerve during the transplant.

“This is the first attempt to inject adult stem cells into the human optic nerve during transplantation in hopes of improving nerve regeneration,” said Dr. Samar Al-Homsi, executive director of the Center for Transplantation and Cell Therapy at NYU Langone. . “We have now demonstrated that the procedure is safe and effective, but we need time to determine whether this procedure plays a role in improving the chance of vision recovery and whether something else can be done to improve this procedure in the future.” Al-Homsi added. The team also transplanted the left eye socket, including the orbital bones.

In addition to the revolutionary eye transplant, surgeons also replaced the nose, left upper and lower eyelids, left eyebrow, upper and lower lips, and the underlying bony areas of the skull, chin, nose and chin.

“The improvement we saw with the eye was exceptional, especially considering the cornea attached to the retina showed excellent blood flow five months after the procedure. This exceeded our initial expectations, as our initial hope was that the eye would survive at least 90 days,” said NYU Langone Transplant Institute’s transplant said surgeon Dr. Bruce Gelb.

“We’re continuing to monitor, and I’m excited to see what we can learn over time.” James spent just 17 days in the NYU Langone ICU after surgery, one of the shortest recoveries among Rodriguez face transplant recipients. So, James began physical and occupational rehabilitation and speech therapy. He has also undergone follow-up surgery to repair the transplant, and will receive dental treatment in the coming months. “Beyond the eye, the quality of Aaron’s face transplant is outstanding,” Rodriguez said.

“You would never think that he had such a procedure so recently. He is beautiful.” James returned to Arkansas with his wife and daughter in September and regained the ability to taste, smell and eat solid foods. He returns to New York City monthly for follow-ups. James said he was looking forward to enjoying a Thanksgiving meal for the first time since his injury. ” said James. “Without their expertise and support my family and I would not have been able to undertake this difficult journey.”

More information: Cleveland Clinic has more information about face transplant surgery.

Source: NYU Langone Health, news release, November 9, 2023