The First Full Face Transplant in the USA

Advances in modern medicine move so fast that sometimes a current headline can seem like a futuristic science fiction story.

Such was the case last week when we learned that a 25-year-old man from Texas (appropriately named Dallas) underwent a 15-hour transplant surgery to receive a .

Dallas Wiens is simply known as “Daddy” to his 3-year-old daughter Scarlette and said in numerous interviews leading up to the surgery that he only wanted to be able to feel her kisses again.

Dallas was horrifically injured in 2008 when he was in a lift crane, or cherry picker, working as a day laborer painting a church.  One of his co-workers shouted to him that he was getting too close to a power line.  But it was too late.  In that moment, the left side of Dallas head touched the electrical line, and he was shocked and severely burned.

Not expected to survive in the first 72 hours after the accident, Dallas pulled through with a will to live that his grandmother called “amazing.”  Dallas endured 22 surgeries while in the burn unit that removed all of his damaged facial features down to the bone, including the skin, muscle, his left eye, teeth, nose and lips.  Doctors grafted skin over his face as a temporary solution

But last week at Brigham and Women’s Hospital in Boston, plastic surgeon Dr. Bohdan Pomahac led a team of more than 30 medical professionals to give Dallas a full face transplant.  .  Dr. Bohdan said that Dallas will his donor or his former self, but rather will be a .  Dallas’ underlying bone structure provides the canvas for the new donor tissue.

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Two other partial face transplants were performed in the U.S. in the last few years.  The first was at The Cleveland Clinic in 2008 for patient Connie Culp who was shot in the face by her husband.  The other was also performed by Dr. Pomahac at Brigham and Women’s Hospital on a man who wished to remain anonymous.  After that surgery in 2009, Dr. Pomahac, for all his medical expertise, still described the process as emotional.   He told reporters that watching the and seeing chalk-white donor tissue turn to a was “surreal.”

Dallas had no health insurance at the time of the accident.  He exhausted his Medicaid benefits shortly after entering the hospital.  But when he became a likely candidate for facial reconstruction and eventual transplant, his treatments were paid for by the U.S. Department of Defense as part of a .4 million grant given to the hospital for transplant research.  The military hopes to use what is learned to help soldiers with severe facial injuries.

The risk of rejection of the donor tissue is high after any transplant, but especially after a facial transplant due to the delicate connections and structures, and Dallas will have to take powerful anti-rejection drugs for the rest of his life.  The new federal health care plan that raised the age limit for children of insured parents to 26 will allow Dallas to help pay for these drugs at least for another year.

Dallas is recovering in good condition and his family said he is able to speak on the phone, an almost impossible task prior to surgery without lips.  His grandfather reported that Dallas said he could have chosen to get bitter or get better.  He chose to get better. Thanks to an incredible team of highly skilled medical professionals who still appreciate the magic of science, Dallas will continue to amaze us.

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