NEW YORK (AP) – Nearly six months after a rare face and hand transplant, Joe DiMeo is once again learning how to smile, blink, pinch, and pinch.
The 22-year-old New Jersey resident underwent surgery last August, two years after being badly burned in a car accident.
“I knew it would be very small 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. “
Experts say it looks like the surgery at NYU Langone Health was a success, but warn it will take time to say for sure.
Surgeons worldwide 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 transplants and double hand transplants are extremely rare and have only been tried twice before. The first attempt was in 2009 on a patient in Paris who died of complications about a month later. Two years later, doctors in Boston tried again on a woman who had been mauled by a chimpanzee, but ended up having to remove the transplanted hands days later.
“The fact that they were able to do it is phenomenal,” said Dr. Bohdan Pomahac, a surgeon at Brigham and Women’s Hospital in Boston who led the second attempt. ‘I know firsthand that it is incredibly complicated. It is a huge success. “
DiMeo will be on lifelong medications to avoid rejecting the transplants, and will continue rehabilitation to get feel and function in his new face and hands.
In 2018, DiMeo fell asleep at the wheel, he said, after working a night shift as a product tester for a pharmaceutical company. The car hit a curb and a utility pole, then turned and burst into flames. Another driver who saw the accident pulled over to save DiMeo.
He then spent months in a medically induced coma and underwent 20 reconstructive surgeries and multiple skin grafts to treat his extensive third degree burns.
When it became clear that conventional surgery couldn’t help him regain full vision or use of his hands, DiMeo’s medical team began preparing for the risky transplant in early 2019.
“They are probably the most unusual in the transplant world,” says Dr. David Klassen, UNOS Chief Medical Officer.
Almost immediately, the NYU team ran into challenges, including finding a donor.
Doctors estimate he had only 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 tone, and hand dominance.
Then in the search for a donor, the pandemic struck and organ donations plummeted. During the New York City Gulf, members of the transplant unit were transferred to work in COVID-19 wards.
In early August, the team finally identified a donor in Delaware and completed the 23-hour procedure a few days later.
They amputated both hands of DiMeo, replaced them mid-forearm and connected nerves, blood vessels and 21 tendons with hair-thin stitches. They also transplanted an entire face, including the forehead, eyebrows, nose, eyelids, lips, both ears, and underlying facial bones.
“The chances of us being successful based on the track record looked slim,” said Dr. Eduardo Rodriguez, who led the medical team of more than 140 people. “It’s not like anyone has done this all that often, and we have some sort of schedule, a recipe to follow.”
So far, DiMeo has shown no signs of rejection from his new face or hands, Rodriguez said.
Since leaving hospital in November, DiMeo has undergone intensive rehabilitation, devoting hours daily to physical, occupational therapy and speech therapy.
“The rehab has been pretty intense,” said DiMeo, and you have to retrain a lot to do things yourself again.
In a recent session, he practiced raising his eyebrows, opening and closing his eyes, pulling his mouth, raising his thumbs, and whistling. DiMeo feels his new forehead and hands getting cold, and often reaches out to push his long hair off 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, but he’s also back in the gym – putting 50 pounds on the couch and practicing his golf swing.
‘You have a new chance in life. You really can’t give up, ”he said.
As with any transplant, the risk of rejection is greatest at first, but indefinitely. The drugs he takes also make him vulnerable to infections for the rest of his life.
“You are never free from that risk,” said Klassen. “Transplantation for every patient is a process that takes place over a long period of time.”
Still, Rodriguez said he is surprised to see that DiMeo has been able to master skills such as zipping up his jacket and putting on his shoes.
“It’s very gratifying for all of us,” said Rodriguez. “There is a tremendous sense of pride.”
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Follow Marion Renault on Twitter: @MarionRenault
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The Associated Press Department of Health and Science is supported by the Science Education Department of the Howard Hughes Medical Institute. The AP is solely responsible for all content.