NEW YORK (AP) – Nearly six months after a rare face and hand transplant, Joe DiMeo is re-learning how to smile, blink, pinch and push.
The 22-year-old New Jersey resident had the surgery last August, two years after he was badly burned during a car accident.
“I knew it was going to be baby steps,” DiMeo recently told The Associated Press. “You have to have a lot of motivation, a lot of patience. And you have to stay strong through everything. ‘
According to experts, the operation at NYU Langone Health appears to have been a success, but they warn it will take a while to make sure.
Worldwide, surgeons have completed at least 18 face transplants and 35 hand transplants, according to the United Network for Organ Sharing, or UNOS, which oversees the U.S. transplant system.
But simultaneous face and double hand transplants are extremely rare and have only been tested twice before. The first attempt was in 2009 on a patient in Paris who died of complications about a month later. Two years later, Boston doctors tried again on a woman who had been abused by a chimpanzee, but eventually had to remove the transplanted hands days later.
“The fact that they can take it out is phenomenal,” said Dr. Bohdan Pomahac, a surgeon at Brigham and Women’s Hospital in Boston who led the second attempt, said. ‘I know firsthand that it’s incredibly complicated. It’s a huge success. ”
DiMeo will use lifelong medication to prevent the transplants from being rejected, as well as ongoing rehabilitation to get sensation and function in his new face and hands.
In 2018, DiMeo slept at the helm, he said, after working a night shift as a product tester for a drug company. The car hit a curb and a utility pole, overturned and burst into flames. Another driver who saw the crash pulled over to rescue DiMeo.
He then spent months in a coma and underwent 20 reconstructive surgeries and multiple skin grafts to treat his extensive third-degree burns.
After it became clear that conventional surgeries could not help him regain his vision or the use of his hands, DiMeo’s medical team began preparing for the risky transplant in early 2019.
“Within the world of transplantation, this is probably the most unusual,” said Dr. David Klassen, medical director of UNOS, said.
Almost immediately, the NYU team encountered challenges, including finding a donor.
According to doctors, he only has a 6% chance of finding a match that is compatible with his immune system. They also wanted to find someone with the same gender, skin color and dominance.
When the pandemic hit, the pandemic and organ donations declined. During the New York City boom, members of the transplant unit were again assigned to work in COVID-19 divisions.
In early August, the team finally identified a donor in Delaware and completed the 23-hour procedure a few days later.
They both amputated DiMeo’s hands and replaced their middle forearm, connecting nerves, blood vessels and 21 tendons with hair-thin sutures. They also transplanted a complete face, including the forehead, eyebrows, nose, eyelids, lips, both ears and underlying facial bones.
“The possibility that we would be successful based on the record seemed slim,” said dr. Eduardo Rodriguez, who led the medical team of more than 140 people, said. “It’s not like someone has done it many times and we have a kind of schedule, a recipe to follow.”
So far, DiMeo has shown no signs of rejecting his new face or hands, Rodriguez said.
Since leaving the hospital in November, DiMeo has been intensively rehabilitated and spends hours daily on physical, occupational and speech therapy.
“Rehab has been pretty intense,” DiMeo said, and it involves a lot “training yourself to do things on your own again.”
During a recent session, he practiced lifting his eyebrows, opening and closing his eyes, pressing his mouth, giving a thumbs up and whistling. DiMeo can feel his new forehead and hands getting cold and regularly stretches his long hair from his face.
DiMeo, who lives with his parents, can now dress and feed himself. He shoots pool and plays with his dog Buster. DiMeo was once an avid gym goer and is also training again – he invests £ 50 and practices his golf swing.
‘You’ve got a new chance at life. You really can not give up, “he said.
As with any transplant, the risk of rejection early on is the highest, but it lasts indefinitely. The medicine he takes also leaves him vulnerable to infections for the rest of his life.
“You’re never free of risk,” Klassen said. “Transplantation for any patient is a process that takes place over a long period of time.”
Still, Rodriguez said he was surprised to see that DiMeo was able to master skills such as putting on his jacket and putting on his shoes.
“It’s very gratifying for all of us,” Rodriguez said. “There’s a great sense of pride.”
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Follow Marion Renault on Twitter: @MarionRenault
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Scientific Education. The AP is solely responsible for all content.