Friday, April 06, 2012

More Miraculous Face Transplants. STAT.

Richard Norris, before and after
Thirty-seven-year-old Richard Lee Norris had lived fifteen years as a recluse, a masked man to all but his closest relatives. His face was a gnarled mass of scarred flesh and useless features, after a close range shooting accident in 1997. Luckily—or not—Norris was not blinded in the accident that blew his face off. He has been able to see clearly the life that was passing him by—and the expressions of horror in the faces of others. And then, one day last month, Norris was able to look in a mirror and see a handsome man looking back.

In a 36-hour operation at the University of Maryland Medical Center in Baltimore, Norris received the “most extensive face transplant ever carried out”, including not only a continuous facial tissue from scalp to clavicle, but also a tongue, both upper and lower jaws, and all their perfectly matched teeth. Faculty surgeon Eduardo Rodriguez, M.D., D.D.S.,
 Dr. Eduardo Rodriguez with transplant team at UMMC
led a team of more than 100 physicians, nurses and professional staff, whose expertise included not only dental and facial reconstruction, but also shock and trauma, for the first time in a face transplant. UMMC houses the R. Adams Cowley Shock Trauma Center, where the critical care concept of the golden hour was coined, and which has long experience in treating just such “high-velocity ballistic facial injuries”. And UMMC’s renowned Division of Transplantation has focused on the anatomic and immunologic challenges to craniofacial transplantation. Research there has found that high amounts of vascularized bone marrow (VBM) may significantly reduce the risk of tissue rejection, reducing the amount of dangerous immunosuppression required over the lifetime of the recipient. The mandible that Norris received is rich in VBM, and expectations, though guarded, are high.

Like the only other full-face transplant in the US, performed by Dr. Bohdan Pomahac and his team at Brigham and Women's Hospital in Boston, Norris’ FFT was paid for by grant funding from the Office of Naval Research (ONR) in the United States Department of Defense. The ONR funds medical research to support military operational medicine and clinical care of returning veterans. In addition to conducting research, the University of Maryland Medical Center trains military medical staff prior to deployment and performs organ transplant surgeries for patients at Walter Reed/Bethesda National Naval Medical Center. At this moment the Department of Defense estimates that as many as 200 wounded soldiers are eligible for an operation like Norris’.

Two hundred. Ready right now. Since 2005, when the first partial face transplant stunned the world, this once unimaginable miracle has already been repeated twenty-three times.

Only twenty three.