Can a combined whole eye and face transplant be safely performed?
Aaron James is a 46-year-old veteran from Arkansas who underwent the world’s first whole-eye and partial face transplant. He is doing “remarkably” well over a year after his pioneering surgery.
In 2021, Aaron James sustained a high-voltage electrical injury that caused severe tissue damage to his face and left eye. As a result of the accident, he also lost his ability to taste, enjoy solid foods, and smell through his nose.
He underwent a combined whole eye and face transplant using personalized surgical devices and a novel microsurgical strategy at a specialized center for vascularized composite allotransplantation.
This complex procedure utilized customized surgical devices and an innovative microsurgical approach at a specialized vascularized composite allotransplantation center
In an interview with the New York Post, Aaron James shared, "I’ve been given the gift of a second chance, and I don’t take a single moment for granted."
To monitor his progress, a health team from NYU Langone has conducted a new study.
Our discoveries over the past year mark promising initial results, laying a foundation for further advancements and ongoing research. We are truly amazed by Aaron’s recovery, with no episodes of rejection,
Dr. Eduardo Rodriguez, Director of the Face Transplant Program and Chair of Plastic Surgery, NYU Langone
He further stated, “Our methodical approach to the matching process, ensuring that Aaron received the most favorable donor match, along with our unique immunosuppression regimen, has set the standard for preventing and avoiding early rejection episodes.”
The surgery was performed at NYU Langone in 2023, involving a team of over 140 surgeons, nurses, and other healthcare professionals. The procedure, which took 21 hours, involved transplanting an entire left eye and part of a face from a single donor onto Aaron.
At 1 year post transplant (postoperative day 366), there was no perception of light in the transplanted eye.
The doctors believe that Aaron’s transplanted eye is responding electrically to light, suggesting that the light-sensitive nerve cells in the eye survived the transplant. This development offers hope that future whole-eye transplants might eventually restore sight.
According to the New York organ procurement organization LiveOn NY, Aaron’s new partial face came from a donor in his 30s, who also contributed to saving three other lives by donating his kidneys, liver, and pancreas.
The surgical team transplanted the left eye socket along with the orbital bones, as well as the nose, left upper and lower eyelids, left eyebrow, upper and lower lips, and segments of the underlying skull, cheek, nasal, and chin bones.
According to the study published, this is the first report of a combined whole-eye and facial transplant, demonstrating allograft survival, including rejection-free graft survival. Electroretinographic measurements also show a retinal response to light stimuli, highlighting the potential for clinical allotransplantation in cases of globe loss.
Ceradini, D. J., Tran, D. L., Dedania, V. S., Gelb, B. E., Cohen, O. D., Flores, R. L., Levine, J. P., Saadeh, P. B., Staffenberg, D. A., Youss, Z. B., Filipiak, P., Baete, S. H., & Rodriguez, E. D. (2024). Combined Whole Eye and Face Transplant. JAMA. https://doi.org/10.1001/jama.2024.12601
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