Source: NYU LANGONE STAFF
What You Should Know:
– A surgical team at NYU Langone Health performed the world’s first whole-eye and partial-face transplant on a 46-year-old military veteran, Aaron James, who survived a high-voltage electrical accident at work.
– The 21-hour surgery was led by Dr. Eduardo D. Rodriguez, director of the Face Transplant Program at NYU Langone along with a team of more than 140 surgeons, nurses, and other healthcare professionals.. James had lost his left eye and suffered extensive facial injuries in a high-voltage electrical accident in June 2021.
Surgical Procedure & Outcomes
Aaron James suffered a 7,200-volt electric shock at work in June 2021, resulting in extensive injuries, including the loss of his left eye, left arm, entire nose and lips, front teeth, left cheek area, and chin down to the bone. The 21-hour surgery involved transplanting the entire left eye and a portion of the face from a single donor, marking the first-ever human whole-eye transplant in medical history and the only successful combined transplant case of its kind.
James was listed for organ donation with the United Network for Organ Sharing (UNOS) in February 2023, and within three months, a potential donor was identified by LiveOnNY, allowing one of the shortest wait times.
Nerve Regeneration
To address the challenge of nerve regeneration, the surgical team injected bone marrow-derived adult stem cells into the optic nerve during the transplant, aiming to enhance nerve regeneration. Collaborations with Depuy Synthes and Materialise, along with state-of-the-art 3D computer surgical planning, contributed to the success of the surgery, providing precise alignment of bones and optimal placement of implantable plates and screws.
Post-Surgery Recovery
James spent only 17 days in the intensive care unit, one of the shortest recoveries among face transplant recipients under Dr. Rodriguez. He has returned home, undergone follow-up surgeries, and continues outpatient rehabilitation. While it’s uncertain if James will regain sight, the transplanted left eye has shown remarkable signs of health, including direct blood flow to the retina, which receives light and sends images to the brain.
The transplanted eye has exceeded initial expectations, showing a viable cornea paired with a retina displaying great blood flow five months after the procedure. Ongoing tests, including electroretinography, will monitor the eye’s health and potential indications toward sight restoration.
“Aaron has been extremely motivated to regain the function and independence he lost after his injury. We couldn’t have asked for a more perfect patient,” said Dr. Rodriguez. “We owe much of our success in this monumental endeavor to the exceptional institutional support we receive at NYU Langone and the unwavering dedication of our world-class team in delivering the highest level of care to our patient. This achievement demonstrates our capacity to embrace the most difficult challenges and drive continuous advancements in the field of transplantation and beyond.”
“Given Aaron needed a face transplant and will be taking immunosuppressive drugs regardless, the risk versus reward ratio of transplanting the eye was very low. Despite the eye being successfully transplanted, from a cosmetic standpoint, it would still be a remarkable achievement,” said Dr. Rodriguez.