A multidisciplinary team of Vall d’Hebron University Hospital, led by Dr. Joan-Pere Barret, head of Plastic Surgery and Burns, have performed the world’s most complex successful face transplant. The team have reconstructed two thirds of the lower face, neck, mouth, tongue and pharynx of a patient who had been affected by a massive arteriovenous malformation for 20 years. The disease caused a progressive deformation of the tissues with the patient suffering from severe vision problems, inhibition of speech and the life-threatening risk of severe bleeding.
The patient had been examined in Mayo Clinic and other hospitals where he was considered inoperable. The evolution of the disease, a progressive deformity and severe bleeding that had put his life at risk, was assessed by the face transplant team of Vall d’Hebron, which considered that the only treatment option for this patient was removing his tumourous tissues and rebuilding his face through a facial transplant. See edited footage of the surgery here.
The highly complex operation was carried out in early February and lasted 27 hours. The team comprised 45 professionals from different departments of the hospital, namely, Plastic Surgery, Anaesthesia, Nursing, Nursing Assistants, Liver Transplant, Transplant Coordinator, Infectious Diseases, Interventional Neuroradiology, Intensive Care Unit, orderlies and all central and support services.
This is the second face transplant carried out in the Vall d’Hebron Hospital. The first, which was the first full face transplant in the world in April 2010. It was performed on a young man who suffered a severe facial deformity caused by a trauma that had left him without a nose and nostrils, and had deformed the patient’s upper and lower jaw, cheekbones, the ethmoid bone area, lips, mouth and soft tissues of the face. This caused the subject serious functional problems, including difficulty in breathing, speaking, swallowing with the patient being fed artificially. The patient is currently living a normal life. All the skin and muscles of the patient’s face, nose, lips, jaw, all teeth, palate and cheek bones were transplanted by using plastic surgery techniques and vascular-nervous microsurgery.
The world’s first partial face transplant was carried out in 2005 in France. Isabelle Dinoire underwent the operation to replace her original face, which had been mauled by her dog.
The current patient’s evolution after the surgery was successful. Now, the 45-year old patient is already at home and only comes to the hospital to do routine check-ups. During the weeks after the current complex facial transplant the patient has been performing rehabilitation treatment and the required immunosuppressant regimen has been adjusted over time.
At this stage the nurses and nursing assistants in the Burn Unit, the Department of Rehabilitation, Physiotherapy and Occupational Therapy, Dietetics and Nutrition Departments, the Department of Psychiatry and Social Services of the Hospital all have played an important role.
Source: Generalitat de Catalunya
