NEW YORK (AP): Nearly six months after a rare face and hand transplant, Joe DiMeo is once again learning to smile, blink, pinch, and squeeze.
The 22-year-old New Jersey resident had the operation last August, two years after he was seriously burned in a car accident.
“I knew it would be baby steps to the end,” DiMeo told The Associated Press recently. “You have to have a lot of motivation, a lot of patience. And you have to stay strong in everything ”.
Experts say it looks like the surgery at NYU Langone Health was a success, but warn it will take a while to say for sure.
Worldwide, surgeons have performed at least 18 facial transplants and 35 manual transplants, according to the United Network for Organ Sharing, or UNOS, which oversees the U.S. transplant system.
But simultaneous face and double-handed transplants are extremely rare and have only been tried twice before. The first attempt was in 2009 against a Paris patient who died about a month later from complications. Two years later, Boston doctors tried it again with a woman who was harassed by a chimpanzee, but eventually had to remove his transplanted hands days later.
“The fact that they can get it is phenomenal,” said Dr. Bohdan Pomahac, a surgeon at Boston’s Brigham and Women’s Hospital who led the second such attempt. “I know first hand that it is incredibly complicated. It’s a huge success. “
DiMeo will take lifelong medications to avoid rejecting transplants, as well as ongoing rehab to get feel and function on your new face and hands.
In 2018, DiMeo fell asleep behind the wheel, he said, after working a night shift as a product tester for a pharmaceutical company. The car crashed into a curb and a utility pole, overturned and burst into flames. Another driver who saw the crash stopped to rescue 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.
Once it became clear that conventional surgeries could not help him regain full vision or use of his hands, DiMeo’s medical team began preparing for the risk of transplantation in early 2019.
“Within the world of transplantation, they are probably the most unusual,” said Dr. David Klassen, chief physician at ONOS.
Almost immediately, the NYU team faced challenges, such as 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 mastery of the hand.
Then, during the search for a donor, the success of the pandemic and organ donations plummeted. During the New York City boom, members of the transplant unit were reassigned to work in COVID-19 rooms.
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, replacing them in the middle forearm and connecting nerves, blood vessels, and 21 tendons with fine sutures. They also transplanted an entire face, including the forehead, eyebrows, nose, eyelids, lips, both ears, and the underlying facial bones.
“The chance that we would be successful according to history seemed slim,” said Dr. Eduardo Rodriguez, who led the medical team of more than 140 people. “It’s not that someone has done it many times before and we have some kind of calendar, a recipe to follow.”
So far, DiMeo has shown no signs of rejecting his new face or hands, Rodriguez said.
Since leaving the hospital in November, DiMeo has been in intensive rehabilitation, devoting daily hours to physical, occupational and speech therapy.
“Rehabilitation was pretty intense,” DiMeo said, and involves a lot of “re-training to do things on your own.”
During a recent session, she practiced raising her eyebrows, opening and closing her eyes, wrinkling her mouth, giving a thumbs up, and whistling. DiMeo can feel his new forehead and hands cool and often stretch to push long hair from his face.
DiMeo, who lives with his parents, can now get dressed and fed. Shoot in the pool and play with your dog Buster. Once an avid gym lover, DiMeo also goes back to exercise – shedding 50 pounds and practicing his golf swing.
“You have a new opportunity to live. You really can’t give up, ”he said.
As with any transplant, the risk of rejection is higher at first, but lasts indefinitely. The medications he takes also leave him vulnerable, for the rest of his life, to infections.
“You’re never free of that risk,” Klassen said. “Transplanting any patient is a process that takes place over a long period of time.”
Still, Rodriguez said he was surprised to see that DiMeo has been able to master skills such as burning his jacket and putting on his shoes.
“It’s very rewarding for all of us,” Rodriguez said. “There’s a huge amount of pride.”
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Follow Marion Renault on Twitter: @MarionRenault
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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.