October 24, 2019Brigham Surgeons Perform First Full Face Transplant for Black Patient
Boston, MA — Robert Chelsea, 68, became the first black patient, and the oldest, to receive a full face transplant in a procedure at Brigham and Women’s Hospital this July. Chelsea, a Los Angeles area resident, suffered burns over 60 percent of his body and face after his car was struck by a drunk driver in 2013. The 16-hour surgery, involving a team of over 45 surgeons, nurses, anesthesiologists, residents and research fellows and led by Bohdan Pomahac, MD, was the ninth face transplant procedure at the Brigham and the 15th nationwide.
“Despite being the oldest face transplant patient at 68, Robert is progressing and recovering remarkably fast,” said Pomahac, the Roberta and Stephen R. Weiner Distinguished Chair in Surgery and director of Plastic Surgery Transplantation at Brigham Health. “We are looking forward to seeing a significant improvement in Robert’s quality of life.”
The wait for a donor was longer than that of previous Brigham face transplant recipients due to the effort to find a match that would work for Chelsea’s skin tone. Chelsea is the first known black full face transplant recipient. Another black patient in Paris received a partial face transplant in 2007.
“It is vitally important for individuals of all races and ethnicities to consider organ donation, including the donation of external grafts, such as face and hands,” said Alexandra Glazier, President and CEO of New England Donor Services. “Unlike internal organs, the skin tone of the donor may be important to finding a match.”
“May God bless the donor and his family who chose to donate this precious gift and give me a second chance,” said Chelsea. “Words cannot describe how I feel. I am overwhelmed with gratitude and feel very blessed to receive such an amazing gift.”
Chelsea’s injuries stemmed from a fiery freeway accident outside of LA in August 2013. Chelsea was sitting in his overheated vehicle on the side of the road when his car was struck by a drunk driver. The vehicle burst into flames, burning Chelsea and drastically altering both his physical function and his appearance. Chelsea remained in a coma for six months and hospitalized for a year and a half. During that time, Chelsea underwent more than 30 surgeries. His lips, part of his nose, and left ear were unable to be reconstructed. After evaluation by Dr. Pomahac, and an extensive screening process, he was listed for a face transplant in March 2018.
Data from a follow-up study of face transplant recipient outcomes, recently published in the New England Journal of Medicine, found that the first Brigham face transplant patients experienced robust return of motor and sensory function of their face, as well as functionality, which allowed them to socially reintegrate in a way that would not have been possible before the transplant. These data indicate that Chelsea is likely to achieve near normal sensation and about 60 percent restoration of facial motor function within a year, including the ability to eat, smile and speak normally.
“Our previous experience has demonstrated that face transplantation is a viable option for patients with severe disfigurement and limited function who have no alternatives,” said Pomahac. “As we continue to expand this treatment to more patients, we are exploring the ways in which we can quantify how much benefit our patients receive as well as identifying opportunities to limit the risks of this transplant through new immunosuppression protocols.”
The Brigham has long been recognized as one of the world’s leaders in transplantation, having performed the first successful human organ donor transplant, a kidney, in 1954, the first heart transplant in New England in 1984, and the first heart-lung transplant in Massachusetts in 1992. The Brigham performed the nation’s first full face transplant in 2011, and the first bilateral hand transplant in New England in 2011.
“I am forever indebted to Brigham and Women’s Hospital, the most amazing surgical and nurse team ever assembled. The place oozes compassion,” said Chelsea.”