Saturday, March 26, 2011

Full face transplant for US man







A 25-year-old man horrifically injured by an accident involving an electric power line has received a full face transplant in the US. It took a team of more than 30 doctors over 15 hours to give Dallas Wiens his new face.

Surgeons who carried out the operation at Brigham and Women's Hospital in Boston have hailed it a success. It follows nearly a year to the day after the world's first full face transplant in Spain.

Mr Wiens, from Texas, was injured in November 2008 when his head touched a high voltage electrical wire. The burns erased all of his facial features.

The surgery has replaced the nose, lips, skin and muscles as well as the nerves that power them and provide sensation. But, unfortunately, the surgeons were unable to give him new eyes to restore his vision.

His surgeons said: "Dallas is doing great. He's meeting all the milestones that he's expected at the present time. ...

via BBC News - Full face transplant for US man.

On March 2011, a surgical team, led by MUDr.Bohdan Pomaha─Ź in Boston hospital has performed full face transplant to a man whom blind, without lips, nose or eyebrows. The patient's sight couldn't be recovered, but he has been able to talk on the phone ... The first full face transplant performed in the US was done on a construction worker. This operation was paid for with the help of the US defense department. They hope to learn from this procedure and use what they learn help solders suffering from facial injuries.

via Wikipedia

Dallas Wiens, 25, lost all of his features — except for a small portion of his chin — when a cherry-picker he was working on maneuvered into a live wire.

In a statement released this morning, the Brigham said that a team of more than 30 surgeons, nurses, anesthesiologists, and residents worked for more than 15 hours to replace Wiens' facial area, "including the nose, lips, facial skin, muscles of facial animation and the nerves that power them and provide sensation." The transplant extended from the mid-scalp to his neck.

"There were no complications. He's doing great, and he's right on the mark with expected progress," said Dr. Bohdan Pomahac, a plastic surgeon who led the transplant team.

At a news conference this morning, Pomahac said, "When I saw Dallas for the first time I was worried there may not be much we can do. The injury was so extensive." Wiens had no nose and lips and had been left blind. Pomahac was concerned Wiens would not have enough nerves left to attach to the nerves and muscles in the donor face, but that turned out not to be the case. ...

via Dallaswiens.com

Good luck to you Dallas. Press conference video here. No word yet on when Dallas will appear in public with his new face. I hope our technology will allow whole eye replacement in his lifetime. The difficulty is that the eye is an extension of the brain and the optic nerve is very complicated.
The optic nerve, which sends visual signals from the eye to the brain, consists of about one million fibers. Because transplanting a whole eye would require that the optic nerve be cut and then reattached, scientists do not expect that this type of procedure will be possible. Researchers are focusing on how to regenerate damaged optic nerves and how to replace damaged retinal cells with healthy transplants. However, this work is in its early stages and it may be many years before there are any findings that could be used to restore vision in humans."  - link

The optic nerve is a bundle of nerve fibers, about the diameter of pencil, which passes through the back of the eyeball and connects to the nerve fiber layer of the retina. - link

Scientists are getting closer towards being able to repair damaged optic nerves. According to scientists at the Harvard Medical School, they have been able to regenerate the optic nerves of rats. They were not able to give the rats their sight back. ... Unfortunately, they could not get the nerve fibres from the retina to hook up to the nerves from the brain properly (so rats were still blind). Dr. Benowitz said it is a mapping problem. We have to retain the proper organisation of fibre projections to the brain. He believes further studies will overcome this problem.

via Cure For Blindness? Optic Nerves Regenerated.

Has a working eye transplant already been done in Russia?
A Russian eye surgeon has made medical history by attempting the first "combined eye transplantation" in the world, taking a retina and cornea from a corpse to "assemble" a left eye in a woman who has been blind for 20 years. Following the controversial operation, Tamara Gorbacheva, 37, a former translator from Kiev in Ukraine, claims that partial sight has been restored and she can detect light and discern simple shapes. ... News of the alleged breakthrough has been met with bewilderment and scepticism among eye experts in Moscow and London. ...

Zinaida Moroz, head of Moscow's cornea transplant and surgery centre, said: "There's nothing scientific to discuss here. Whole eye transplants are not possible today."

But Prof Muldashev acknowledges that impossibility; it is why he has dubbed his operation "combined eye tranplantation" in which 70% of the restored eye is regenerated tissue stimulated by a biomaterial treatment called Alloplant, which he and his colleagues in Ufa developed in the 1970s and have been refining ever since.

Alloplant is manufactured from the tissue of fresh corpses. In Russia, legislation allows any organs to be taken from a body unless the person expressly proscribed such an action while alive.

Prof Muldashev said that he took the donor's eye and extracted the cornea and the retina. He removed Ms Gorbacheva's atrophied eyeball, and laid the Alloplant - dead tissue - at the base of the eye. The retina and cornea were transplanted onto the Alloplant, a process requiring a total of 200 stitches. He claims the eye then effectively rebuilt itself. "It's like eye-cloning, self-regeneration," said Prof Muldashev. "This has never been done before and honestly we don't fully understand what's happened here."

He estimated the cost of the surgery at $100,000 ...
via GuardianUK

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