Man's double hand & face transplant may be first to succeed

In August, car crash survivor Joe DiMeo underwent surgery at NYU Langone Health to have his badly burned face and hands replaced with those of a donor.

This complicated procedure — a double hand and face transplant — had only been attempted twice before. Both times, it ended in failure.

One recipient developed an infection and died within a month of the surgery, and the other had to have their new hands removed due to transplant rejection.

Five months after the surgery, DiMeo’s new face and hands show no signs of rejection, prompting NYU Langone to hail the operation as the world’s first successful double hand and face transplant.

First-of-Its Kind Face Transplant

DiMeo was driving home from his night shift at work in July 2018 when he fell asleep behind the wheel, causing the crash that left him with third-degree burns over 80 percent of his body.

After 20 reconstructive surgeries, he still had extensive injuries that affected his vision and ability to use his hands. That’s when his doctors decided that a double hand and face transplant was his best option for resuming an independent life.

“Joe was an ideal candidate for this procedure; he’s extremely motivated and dedicated to recovering the independence he lost after his accident,” Eduardo D. Rodriguez, who led the operation, said in a press release.

Before the doctors could give DiMeo a new face and hands, though, they needed to find a suitable donor — and that was a challenge.

Due to all of DiMeo’s previous skin grafts and blood transfusions, his immune system was incredibly sensitive — based on a test commonly given to organ recipients, his doctors determined he was likely to reject 94% of donor organs.

From the 6% he wasn’t likely to reject, the doctors needed to find a donor whose bone structure and skin tone was similar to his.

Ten months after DiMeo was added to the donor list, his doctors found their unicorn donor in Delaware, with the help of organ donor program Gift of Life.

“This transplant was possible because a selfless family said yes to this unique donation,” Richard D. Hasz Jr., vice president of clinical services for Gift of Life, said in the press release.

“The donor’s mother shares that she is proud and comforted that her son was able to help another young man while also saving and healing others through organ and tissue donation,” he continued.

Once the NYU Langone team had their donor, the next step was performing the double hand and face transplant, which they had practiced nearly a dozen times in the year prior — no easy feat given that many members of the team were being reassigned to COVID-19 units.

The complicated procedure required six surgical teams: one for each of the four hands and two faces involved. It took 23 hours, but the practice paid off.

“Ultimately, it went better than I ever expected,” Rodriguez said.

Avoiding Transplant Rejection

DiMeo has undergone several smaller follow-up surgeries since his double hand and face transplant. He also dedicates up to five hours a day to rehabilitation, which involves everything from speech therapy to learning how to whistle.

“Ultimately everything we do with him is with the goal of getting him back to the activities of everyday life he enjoyed before,” April D. O’Connell, clinical specialist for hand and upper extremity rehabilitation, said in the press release.

NYU Langone transplant surgeon Bruce E. Gelb credits a unique immunosuppression regimen and close monitoring with the team’s ability to avoid transplant rejection so far.

You got a new chance at life. You really can’t give up.

Joe DiMeo

However, while the danger of rejection lessens with time, it never goes away completely with transplants —  DiMeo will need to take meds for the rest of his life to try to prevent it.

That’s why it’s hard to say whether or not his is the first successful double hand and face transplant. Is five months without rejection enough? A year? Ten years?

Whatever the case, this is clearly the most successful attempt to date, and DiMeo is making the most of it — since the operation, he’s been weight training, playing with his dog, and even practicing his golf swing.

“You got a new chance at life,” he told the Associated Press. “You really can’t give up.”

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