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Nearly six months after a rare face and hand transplant, American Joe DiMeo is relearning how to smile, blink, pinch and squeeze.
The 22-year-old New Jersey resident underwent surgery last August, two years after sustaining severe burns in a car accident.
“I knew it would be small steps,” DiMeo said. The Associated Press Recently. “You have to have a lot of motivation, a lot of patience. And you have to stay strong in everything. “
Experts say it looks like the surgery at NYU Langone Health was a success, but they warn it will take some time to say for sure.
Worldwide, surgeons have completed at least 18 face transplants and 35 hand transplants, according to the United Network for Organ Sharing, or UNOS, which oversees the US transplant system.
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But simultaneous face and double hand transplants are extremely rare and have only been tried twice before. The first attempt was in 2009 on a patient in Paris who died about a month later from complications. Two years later, Boston doctors tried again with a woman who was mutilated by a chimpanzee, but had her transplanted hands removed days later.
“The fact that they were able to pull it off is phenomenal,” said Dr. Bohdan Pomahac, a surgeon at Brigham and Women’s Hospital in Boston, who led the second such attempt. “I know firsthand that it is incredibly difficult. It is a great success. “
Mark Lennihan / AP
Joe DiMeo demonstrates how he can fix his hair.
DiMeo will take lifelong medications to avoid rejecting transplants, as well as ongoing rehabilitation to gain sensitivity and function in his new face and hands.
In 2018, DiMeo fell asleep at the wheel, he said, after working a night shift as a product tester for a pharmaceutical company. The car collided with a sidewalk and a utility pole, flipped over and burst into flames. Another driver who saw the accident stopped to rescue DiMeo.
Subsequently, he spent months in a medically induced coma and underwent 20 reconstructive surgeries and multiple skin grafts to treat his extensive third degree burns.
Mark Lennihan / AP
Joe DiMeo plays ball with his dog Buster in his backyard.
Once it became clear that conventional surgeries could not help him regain full vision or use of his hands, the DiMeo medical team began preparing for the risky transplant in early 2019.
“Within the world of transplants, they are probably the most unusual,” said Dr. David Klassen, UNOS medical director.
Almost immediately, the NYU team was faced with challenges, including finding a donor.
Doctors estimated that he only had a 6 percent chance of finding a compatible match with his immune system. They also wanted to find someone with the same gender, skin tone, and hand control.
Mark Lennihan / AP
Dr. Eduardo Rodríguez has Joe DiMeo demonstrate flexibility in his new hands at NYU Langone Health in New York.
Then, while searching for a donor, the pandemic hit and organ donations plummeted. During the New York City boom, members of the transplant unit were reassigned to work in the Covid-19 rooms.
In early August, the team finally identified a donor in Delaware and completed the 23-hour procedure a few days later.
They amputated both of DiMeo’s hands, replacing them in the middle of his forearm and connecting nerves, blood vessels and 21 tendons with hair-thin sutures. They also transplanted a full face, including the forehead, eyebrows, nose, eyelids, lips, ears, and underlying facial bones.
Mark Lennihan / AP
Physical therapist Eric Ross, right, watches as Joe DiMeo exercises.
“The chance that we would be successful based on the track record seemed slim,” said Dr. Eduardo Rodríguez, who led the medical team of more than 140 people. “It’s not that someone has done this many times before and we have a kind of schedule, a recipe to follow.”
So far, DiMeo has shown no signs of rejecting his new face or hands, Rodriguez said.
Since leaving the hospital in November, DiMeo has been in intensive rehab, spending hours a day on physical, occupational and speech therapy.
“The rehab was pretty intense,” DiMeo said, and involves a lot of “retraining to do things on your own again.”
Mark Lennihan / AP
DiMeo will take medications for life to avoid rejecting transplants.
During a recent session, she practiced raising her eyebrows, opening and closing her eyes, pursing her mouth, raising her thumbs, and whistling. DiMeo may feel his forehead and new hands grow cold, and he often reaches out to push long hair away from his face.
DiMeo, who lives with his parents, is now able to dress and feed himself. He shoots pool and plays with his dog Buster. Once an avid gym fan, DiMeo is working out again, too – lifting 50 pounds and practicing his golf swing.
“You have a new chance in life. You really can’t give up, “he said.
Mark Lennihan / AP
Dr. Eduardo Rodríguez makes Joe DiMeo demonstrate flexibility and strength in his hands.
As with any transplant, the danger of rejection is greatest at first, but lasts indefinitely. The medications you take also leave you vulnerable, for the rest of your life, to infection.
“You are never free from that risk,” Klassen said. “Transplantation for any patient is a process that takes place over a long period of time.”
Still, Rodriguez said he’s surprised to see that DiMeo has been able to master skills like buttoning his jacket and putting on his shoes.
“It’s very rewarding for all of us,” Rodriguez said. “There is a tremendous sense of pride.”
