A woman was subjected to a face transplant in the same hospital where the first operation of this type in history was achieved. And he starred in another milestone: the first face transplant with a deceased donor euthanasia of the world.
The surgery was in Hebron Valley Hospitalin Barcelona, Spain. On Monday, the medical center reported the news and gave details of the operation.
The patient, who had suffered a necrosis of facial tissue due to bacterial infectionnow bears the face of a person who died from PRAM (Provision of Aid in Dying).
On this aspect, the Dra. Elisabeth Navasmedical coordinator of Donation and Transplants at the hospital, highlighted that the donor demonstrated “a degree of maturity that leaves you speechless” for having decided to give a second chance to someone who needed it.
In this case, the recipient required a type I face transplant, that is, the central part of the face.
How was the operation
As explained by Dr. Joan-Perre Barrethead of the Plastic Surgery and Burns Service at the Vall d’Hebron University Hospital, face transplants are carried out when the patient has lost areas of the face that cannot be restored with other common surgical techniques.
In the end, what is implemented is skin, adipose tissue, peripheral nerves, facial muscles and bone. The structures “must be anastomosed and reconstructed” with “a complex three-dimensional arrangement.”
“The objective is reconnect all structures in the receivercreating a new face that comes to life again, is functional and can develop vital functions normally,” highlights the professional.
To carry out the operation, it is sought that the donor and recipient match in sex, blood group and cranial proportions.
Then, a trusted person of the recipient is interviewed by a social work, psychiatry and psychology team to act as a liaison with the medical team.
Once authorized to perform the operation by the Region, the donor is sought, who is subjected to CT scans to create a 3D digital model of their face that makes the job easier for the surgeons. With the model, a semi-rigid silicone mask and a bone cutting guide are made.
In the Catalan hospital, the bases of the transplant are «the techniques of neurovascular microsurgeryboth to perform the extraction and implantation and to guarantee maximum functionality in the recipient, expressiveness and facial sensitivity, as well as the techniques of the Plastic Surgery (department).
After the operation – which usually lasts between 15 and 24 hours and involves around 100 professionals – the patient spent a month hospitalized.
“Initially, the patient’s face is in a hypotonic phasewithout movement because the nerve connections have not yet been established. We work with the face to stimulate innervation, using tools such as a mirror, different textures and images of the patient to remember those movements and the visual perception of the face,» explains the Dra. Daniela Issafrom the Physical Medicine and Rehabilitation Service.
The first face transplant in history, also in Vall d’Hebron
The first total (not partial) face transplant in history is reported on March 27, 2010 also in Vall d’Hebron, with a graft that included all the soft tissues and part of the underlying bone structure; The surgery lasted about 24 hours and the team was led by Dr. Barret.
According to the official Vall d’Hebron site, a total of 54 face transplants and only seven centers in the world performed three or more transplants (the Catalan one carried out three), since a lot of experience and resources are needed.
