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Almost six months after a rare face and hand transplant, Joe DiMeo is relearning to smile, blink, pinch and squeeze.
The 22-year-old New Jersey resident underwent the operation last August, two years after being badly burned in a car crash.
“I knew it would only be small steps,” DiMeo told The Associated Press. “You have to have a lot of motivation, a lot of patience. And you have to stay strong regardless.
Experts say it appears the surgery at NYU Langone Health was successful, but warn it will take some time to be sure.
Around the world, surgeons have performed at least 18 face transplants and 35 hand transplants, according to the United Network for Organ Sharing, or UNOS, which oversees the US transplant system.
But simultaneous face and double hand transplants are extremely rare and have only been tried twice before. The first attempt took place in 2009 on a Parisian patient who died about a month later from complications. Two years later, doctors in Boston tried it again on a woman who had been mutilated by a chimpanzee, but who ultimately had to remove the transplanted hands a few days later.
“The fact that they can do it is phenomenal,” said Dr. Bohdan Pomahac, a surgeon at Brigham and Women’s Hospital in Boston, who led the second such attempt. “I know firsthand that it’s incredibly complicated. It is a huge success.
DiMeo will take lifelong medication to avoid transplant rejection, as well as ongoing rehabilitation to gain feel and function in his new face and hands.
In 2018, DiMeo fell asleep at the wheel, he said, after working nights as a product tester for a pharmaceutical company. The car struck a sidewalk and an electric pole, overturned and caught fire. Another driver who saw the crash pulled over to save DiMeo.
Afterwards, he spent months in a medically induced coma and underwent 20 reconstructive surgeries and several skin grafts to treat his severe third degree burns.
Once it became clear that conventional surgeries could not help her regain full vision or use of her hands, DiMeo’s medical team began preparing for the risky transplant early in her life. 2019.
“In the world of transplantation, they are probably the most unusual,” said Dr David Klassen, UNOS Chief Medical Officer.
Almost immediately, the NYU team encountered challenges, including finding a donor.
Doctors estimated that he had only a 6% chance of finding a match compatible with his immune system. They also wanted to find someone with the same gender, skin tone, and hand dominance.
Then during the search for a donor, the pandemic struck and organ donations plummeted. During the New York push, members of the transplant unit were reassigned to work in COVID-19 departments.
In early August, the team finally identified a donor in Delaware and completed the 11-hour procedure a few days later.
They amputated both of DiMeo’s hands, replacing them in the middle of the forearm and connecting the nerves, blood vessels and 21 tendons with sutures as fine as hair. They also transplanted a complete face, including the forehead, eyebrows, nose, eyelids, lips, both ears, and the underlying facial bones.
“The possibility of us succeeding based on our track record seemed slim,” said Dr Eduardo Rodriguez, who led the medical team of more than 140 people. “It’s not that someone has done it several times already and we have some sort of schedule, a recipe to follow.”
So far, DiMeo has shown no signs of rejection of his new face or new hands, said Rodriguez, who revealed the details of the transplant on Wednesday.
Since leaving the hospital in November, DiMeo has been in intensive rehabilitation, dedicating hours to physiotherapy, occupational therapy and speech therapy daily.
“The rehabilitation has been pretty intense,” DiMeo said, and involves a lot of “retraining yourself to do things on your own again.”
In a recent session he practiced raising his eyebrows, opening and closing his eyes, narrowing his mouth, raising his thumb and whistling. DiMeo can feel his new forehead and his hands turning cold, and often reaches out to push his long hair back from his face.
DiMeo, who lives with his parents, can now dress and feed himself. He shoots at pool and plays with his dog Buster. Once a gym enthusiast, DiMeo is training again – weighing 50 pounds and practicing his golf swing.
“You have a new chance to live. You really can’t give up, ”he says.
As with any transplant, the risk of rejection is greatest early on, but lasts indefinitely. The drugs he takes also make him vulnerable to infections for the rest of his life.
“You are never safe from this risk,” Klassen said. “Transplantation for any patient is a process that takes place over a long period of time.”
Still, Rodriguez said he was amazed that DiMeo was able to master skills like closing his jacket and putting on his shoes.
“It’s very rewarding for all of us,” Rodriguez said. “There is an immense sense of pride.”
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