A man from New Jersey who underwent the world’s first successful face and double hand transplant in August 2020—two years after 80% of his body was burned in a car accident—spoke out for the first time on February 3 about how transplant surgery changed his life.
Jo DiMeo, 22, had the surgery—which took 23 hours, 16 doctors, and two operating rooms—at NYU Langone Health Center in New York City. Before the surgery, doctors warned him he only had a 6% chance of finding a match for his immune system, due to the 20-plus reconstructive procedures he’d already undergone. But following a national search, the match came in the form of an unidentified donor in Delaware.
DiMeo revealed that when he saw his new face for the first time, it “didn’t seem real at first,” he said on Good Morning America on February 3. “The swelling comes down every day,” he said. “I see my cheekbones now.”
DiMeo also expressed gratitude to his donor’s family. “I don’t know how to thank someone that gives you a second chance at life,” he said.
Five months after his transplant surgery, DiMeo is now able to dress, feed himself, and throw a ball to his dog, Buster. He’s started resistance training with his new hands using light free weights and machines, and has even been able to start practicing his golf swing again.
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What happens during a face and hand transplant?
During a face transplant, part or all of the face is replaced with tissue from a deceased donor. NYU Langone confirmed to Health that DiMeo had a full face transplant, which included the forehead, eyebrows, both ears, nose, eyelids, lips, and underlying skull, cheek, nasal, and chin bone segments.
DiMeo’s hand transplants involved both hands to the mid-forearm, including the radius and ulna, three dominant nerves to the hand, six vessels requiring vascular connections, and 21 tendons.
Both his face and hands were transplanted within 23 hours—a record-breaking effort thanks to cutting-edge technology and expansive operating rooms, which allowed six surgical teams, led by Eduardo D. Rodriguez, MD, DDS, the Helen L. Kimmel Professor of Reconstructive Plastic Surgery and chair of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone, to simultaneously operate in both the donor and recipient rooms.
The first partial face transplant was conducted on a French woman named Isabelle Dinoire, whose face was mauled by her dog. Although the 2005 operation was initially deemed a success, Dinoire reportedly went on to experience two incidents of tissue rejection, one which led to partial loss of her lips. She died in early 2016 after developing two forms of cancer, which may have been partly because of the immunosuppressant drugs she had to take.
All transplant recipients must take these meds for the rest of their life to reduce the risk of their body rejecting the “foreign” tissue, and the side effects include potentially fatal infections and cancer.
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What’s the outcome for face transplant patients?
In 2018, the first long-term look at how face transplant recipients responded to the procedure was published in the New England Journal of Medicine. The authors analyzed six patients who received face transplants between March 2011 and October 2014. At around five years post-surgery, the patients reported, on average, 60% of normal facial motor function, including a significant improvement of “sensory return,” e.g. feeling hot and cold on their face.
The researchers also found that the patients’ quality of life improved, and their risk of depression was lowered, after they received a face transplant.
According to NYU Langone, only two previous, simultaneous face and hand transplant attempts are known to have been performed. However, in each case there was an adverse outcome. One patient ultimately died due to infectious complications, and another required removal of the hands after they failed to thrive.
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Who is a candidate for this rare type of transplant?
Every transplant candidate is considered on their own merits. After a large number of reconstructive surgeries, DiMeo’s plastic surgeon realized conventional surgery could do nothing else to improve the function of his face or hands. Even after all the reconstruction, he still had extensive injuries, including amputated fingertips, severe facial scarring, and no lips or eyelids. These impacted his vision and daily activities, and they severely limited his ability to live a functional and independent life. These major limitations forced DiMeo’s mother acting as his primary caregiver.
DiMeo’s character and attitude may have also made him the right person to undergo such a grueling surgery. “Joe was an ideal candidate for this procedure; he’s extremely motivated and dedicated to recovering the independence he lost after his accident,” Dr. Rodriguez said in a press release.
“This is an individual with a tremendous amount of courage, who went into an operation not knowing if he’s going to come out alive,” Dr. Rodriguez told Good Morning America. “He just has that mentality and hope and a mental strength that he will succeed. And that is a major element that has helped him heal and help him get back to normal.”
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