Ground-breaking doctors from Houston Methodist Hospital and the MD Anderson Cancer Centre in Austin, Texas have carried out the world's first partial skull and scalp transplant.
The craniofacial tissue transplant operation - which took around 15 hours to conduct, 2 years to plan and involved more than 50 healthcare professionals - was carried out two weeks ago on a 55 year old man named Jim Boysen.
A delighted Jim joked about it helping with his hair loss, telling The Associated Press, "It's kind of shocking, really, how good they got it. I will have way more hair than when I was 21".
This innovative approach was conceived in response to Jim's unique health situation. A diabetic since childhood, Jim had a kidney and pancreas transplant in 1992; this meant taking immune-suppressant drugs to prevent organ rejection. These made him more susceptible to cancer. Jim developed leiomyosarcoma - a rare type of cancer that affects muscles under the scalp.
MD Anderson's reconstructive plastic surgeon Dr. Jesse Selber, the co-leader of Jim's surgical team, told The Guardian, “He had series of cancers of the scalp and skull that were treated with various surgeries and radiation that left him with a large wound that was all the way down to his brain.”
In addition to the head wound, Jim found the immune suppressants also prevented his body from healing. As his transplanted organs started to fail, his doctors were faced with a conundrum as they could not perform a new kidney-pancreas transplant whilst he had an open wound. Continues below.
Dr. Selber came up with the novel idea of a partial skull and scalp transplant, as well as a simultaneous organ swap and partnered with Houston Methodist Hospital, which has established transplant expertise.
LifeGift, an organ-procurement organisation, conducted an extensive search for the perfect donor. Eighteen months later they found their match and the unidentified donor provided all organs for the operations. Jim later praised the match, noting how similar the skin and hair colouring was.
Although other successful skull transplants have been carried out using 3-D printed artificial implants or bone grafts, this cutting edge surgery is being hailed as the first skull-scalp transplant to use a human donor.
Around 12 doctors, including microsurgeons, neurosurgeons and reconstructive surgeons, and a further 40 health workers, made Dr. Selber's idea a reality.
Following a 10-by-10 inch skull graft, Jim was given a 15-inch-wide scalp graft from just above his forehead to his crown. The transplanted area ends one inch above his right ear and two inches above his left.
Houston Methodist plastic surgery team-leader Dr. Michael Klebuc, said, "We had to connect small blood vessels about one-sixteenth of an inch thick. It's done under an operating microscope with little stitches about half the thickness of a human hair, using tools like a jeweller would use to make a fine Swiss watch".
Amazingly, Jim Boysen has confirmed he has sensation in the new scalp already - including feeling it sweating in his warm hospital room. He told a press conference: "That kind of shocked the doctor. He was doing a test yesterday and I said, 'Ouch I feel that.' He kind of jumped back... I'm still kind of in awe of it."
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