A team at R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center, completed a 36 hour operation to replace an entire patient’s face, including teeth, both jaws and tongue. The procedure represents the largest face transplant on record.

The transplant team was led by Eduardo D. Rodriguez, M.D., D.D.S., associate professor of surgery at the University of Maryland School of Medicine and chief of plastic, reconstructive and maxillofacial surgery.

Dr. Rodriguez confirmed :

“We utilized innovative surgical practices and computerized techniques to precisely transplant the mid-face, maxilla and mandible including teeth, and a portion of the tongue. In addition, the transplant included all facial soft tissue from the scalp to the neck, including the underlying muscles to enable facial expression, and sensory and motor nerves to restore feeling and function … Our goal is to restore function as well as have aesthetically pleasing results.”

The donor ‘s name remains anonymous, but he offered not only his face but other organs that were part of a massive 72 hours of procedures, saving five other lives with organ donations. Four of the operations took place at The University of Maryland Medical Center, one of the busiest transplant centers in the world.

The recipient’s name is Richard Lee Norris of Hillsville, Virginia, a 37 year old man, who was injured in 1997 from a gun accident. Since the injury he has undergone many life-saving and reconstructive surgeries. Mr. Norris lost his lips and nose and had limited movement of his mouth. Mr. Norris first discussed reconstruction with Dr. Rodriguez in 2005.

The scientific team that included Drs. Stephen Bartlett, Rolf Barth, and Eduardo Rodriguez who focused on the anatomic and immunologic challenges to craniofacial transplantation. The culmination of their work is this record breaking surgical achievement.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president of medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine said in a statement :

“The future of medicine depends on rapid translation of research and creating high-performing teams. The face transplant is a perfect example of the life-changing options we can provide for our patients when we combine the expertise of our research and clinical teams to pursue procedures that would have seemed unfathomable not so long ago.”

Dr. Bartlett received grant funding from the Office of Naval Research, a branch of the Dept. of Defense. Formally known as a vascularized composite allograft, the procedure is seen as a means of supporting war veterans who return with severe facial injuries. Military funding has supported the University of Maryland in assisting the Department of Defense to develop military medicine over the years. The University has provided training to staff at the Walter Reed/Bethesda National Naval Medical Center, while the University team benefited from gaining experience of high-velocity ballistic facial injuries.

Thomas M. Scalea, M.D., Francis X. Kelly Professor of Trauma Surgery, director, Program in Trauma, University of Maryland School of Medicine, and physician-in-chief, R Adams Cowley Shock Trauma Center explains :

“A project like the face transplant requires multi-disciplinary collaboration between numerous clinical services and in many ways is very similar to trauma care … Because we have an infrastructure built around multi-disciplinary care, it made sense for the facial transplant program to be housed at the Shock Trauma Center in the University of Maryland Medical Center.”

The University of Maryland Medical centre is also involved in developing new ways to prevent organ rejection and minimizing the side effects of long-term immunosuppressive use, medication that is necessary to prevent the body’s immune system from attacking the transplanted organs and tissue.

Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center, announced :

“The Medical Center staff is honored to care for patients and families facing such tremendously complex medical challenges … The resources and talent that made this complex organizational effort a reality was months in the making and touched all areas of the hospital.”

Written by Rupert Shepherd