SC Connecticut News

Since 2005, a total of 50 face transplants have been conducted globally, with Dr. Bohdan Pomahac performing 10 of these surgeries. Dr. Pomahac is the Frank F. Kanthak Professor of Surgery and chief of plastic and reconstructive surgery at Yale School of Medicine. The field has been limited by the small number of procedures and surgeons worldwide.

Recently, experts in this specialized area have collaborated to share data for the first time. Their findings were published in JAMA Surgery, detailing the outcomes of the world's first 50 face transplants performed on 48 patients across North America, Europe, and Asia.

“There’s great promise in people coming together to synthesize our knowledge,” said Dr. Pomahac. “We’re getting to the point where it’s critical to build consensus in the field.”

The study examined results among recipients who underwent this complex form of transplant surgery due to severe facial trauma from burns or gunshot wounds affecting central features like the nose, lips, and eyelids. Despite challenges, most patients have had positive outcomes.

Five years post-surgery, 85% of recipients were alive with their transplants intact; however, some faced complications such as death or permanent rejection. By ten years after surgery, success rates stood at 74%. Skin transplants are challenging due to immune cell richness but show comparable success rates to solid organ transplants.

Recipients require lifelong immune suppression because skin is prone to rejection. Patients must take medication that mildly suppresses their immune system indefinitely and may need stronger doses if rejection occurs within the first year post-surgery.

“There’s no question that we improve the quality of life of the patients immensely,” Dr. Pomahac noted while acknowledging that transplant recipients become slightly chronically ill due to altered immune responses.

In ongoing research funded by the U.S. Department of Defense, Dr. Pomahac's team aims to establish standard guidelines for face transplantation by examining not only rejection but also movement and sensation recovery in transplanted faces.

All ten patients operated on by Dr. Pomahac regained about 50-60% normal motor function post-transplantation, allowing them to express emotions such as smiling partially and improving speech impediments caused by initial trauma.

While progress continues in face transplantation surgery through collaboration among providers, Dr. Pomahac anticipates significant advancements from improved immune-suppressing medications—a key research focus—potentially expanding applicability beyond current patient numbers.

“If medications could be developed that allow patients to successfully retain their transplants without causing chronic immune suppression,” he said, “there’s huge potential that the techniques we have developed could be broadly applicable to vast numbers of patients.”