Arkansas Man's Life Transformed with Groundbreaking Whole-Eye and Partial Face Transplant
A groundbreaking medical breakthrough offers hope to an Arkansas man as he becomes the first person to receive a whole-eye and partial face transplant A moment of unexpected transformation and renewed possibilities
Meagan James witnessed a moment she never anticipated - the surgical team at NYU Langone Health in New York accomplished the unprecedented feat of performing the world's first successful whole-eye transplant in a living individual, her husband, Aaron James.
Aaron had a life-altering accident at work which resulted in the loss of his left eye and a portion of his face. However, he was fortunate enough to receive a partial face transplant, along with a newly bestowed window to his soul.
During the initial moment when Meagan gazed into her husband's recently transplanted eye, she observed the swelling, typical of the post-surgery phase, and also noticed that the eye appeared brown in color. It is worth mentioning that Aaron's original eye color is a captivating ocean-blue.
She also glimpsed his newly-shaped nose, lips, and cheek adorned with a hint of burgeoning beard stubble. What she saw was a countenance brimming with appreciation, and at that moment, overwhelming emotion washed over her.
Her heart burgeoned with joy for the man she had spent two decades of her life with.
"It was a crazy, great, weird, strange, ecstatic, happy feeling," Meagan said. "I was just happy he made it through, and everything was good in the moment."
Aaron James and wife Meagan kiss for the first time after his whole-eye and partial face transplant surgery.
NYU Langone Health
In late May, NYU Langone Health's team of over 140 surgeons successfully performed Aarons transplantation procedure, which took approximately 21 hours. This groundbreaking surgery involved the transplantation of an entire left eye and certain facial parts from a single donor, marking a significant milestone in the field of medicine.
Aarons medical team reports that his eye is displaying impressive signs of recovery, indicating its remarkable health. Despite the current inability to see through the eye, Aaron maintains hope that his vision may eventually develop over time, fueled by the potential advancements this pioneering procedure could bring to transplant medicine.
"Thats really my biggest hope," Aaron said. "If I can see out of it, thats great. But if itll kick-start the next path in the medical field, then Im all for it."
A life-changing accident
According to Meagan, seeing Aaron's new eye and face was less surprising than seeing him on the night of his accident. Aaron, a 46-year-old military veteran residing in Arkansas, was employed as a high-voltage power lineman. In June 2021, while working alongside his colleagues in Mississippi, his face inadvertently made contact with a live wire.
Aaron sustained severe injuries to his face, which included his left eye, nose, lips, left cheek area, and chin, as well as his left arm, due to a 7,200-volt electric shock. While in Arkansas, Meagan and their high school daughter, Allie, had just finished shopping at the grocery store when Meagan received a call on her phone. Although she didn't recognize the number, she answered and heard alarming words such as "Aaron," "accident," and "serious."
Meagan wasted no time as she hastily packed a bag upon arriving home. She embarked on a lengthy four and a half hour drive to reach Mississippi, where Aaron was currently receiving care at a nearby hospital. As she made her way, her phone rang once more, this time with a call from a doctor. With apprehension, the doctor detailed Aaron's condition, revealing that he had suffered an electrocution.
Desperately seeking reassurance, Meagan anxiously inquired, "Is he alright? Will he be alright?" The doctor's response remains vivid in her memory, as they solemnly stated, "I can only assure you that he will survive until your arrival."
Meagan recalls how she used to remind Aaron to practice caution every morning prior to his commute. Even now, she reflects on the day of his accident, pondering whether she uttered those very words of caution to him.
Oh, my goodness, his face is gone
Meagan stayed with Aaron throughout his journey to various medical centers for advanced treatment, reconstructive surgeries, and the eventual amputation of his left arm.
Once he was transported to a burn unit in Dallas, Allie, who was temporarily residing with her grandmother, had the opportunity to visit him.
"When I laid eyes on him, his chinbone was fully exposed," Allie remarked.
"I could vividly observe his eye socket and every intricate detail. I was literally looking at his bare skull, and that aspect completely unnerved me. I was struck with a mixture of shock and disbelief, exclaiming, 'Oh, my goodness, his face has vanished'," she recalled. "My primary concern revolved around his condition and how he would recover once he regained consciousness and awareness."
Aaron claimed to have absolutely no recollection of the accident, stating that he simply went about his usual routine, only to regain consciousness six weeks later in Dallas, Texas. "It's a strange sensation, waking up unexpectedly in a hospital," he expressed.
Aaron saw himself for the first time after the accident while lying in his hospital bed in Dallas. He requested Meagan to capture a photograph, although she was initially hesitant. "Are you sure?" she inquired, to which Aaron replied confidently, "Yeah, it'll be alright."
"He recalled the moment when she captured an image and swiftly rotated the phone, prompting me to respond with a sense of dismay, realizing that this was a problematic situation," he remembered. "Although I felt alright, I was aware that we would face significant challenges in the journey that lay ahead."
Meagan had been informed about the possibility of a face transplant by Aaron's medical care team. When she subsequently broached the subject with him, he expressed strong support and enthusiasm, declaring that he was fully in favor of it.
"As soon as the face transplant got talked about, thats when I thought, Man, this is a big deal, because they just dont do those every day," he said.
Surgeon Dr. Eduardo Rodriguez with Aaron James before his whole-eye and partial face transplant.
NYU Langone Health
Dr. Eduardo Rodriguez, the director of NYU Langone Health's Face Transplant Program, and his colleagues in New York were informed about Aaron's case by specialists in Texas. Upon gaining further knowledge about Aaron's accident and the resulting injuries, Rodriguez expressed astonishment at Aaron's survival.
Witnessing him walk after being at the brink of defeat in the hospital due to multiorgan system failure and reliance on a breathing tube - questioning his survival and potential neurological damage - is truly astounding," Rodriguez expressed admirably.
"It truly testifies to the advancements in modern medicine," he added. "It serves as a testament to the strength of both the patient and his family. Furthermore, it hints at some divine intervention, as it wasn't his moment to depart in these circumstances."
You have to have a patient zero
Even after Aarons medical team in Texas had surgically removed his left eye due to severe pain, discussions regarding the feasibility of a transplant persisted. Rodriguez and his associates in New York requested the Texas team to retain as much of the optic nerve as feasible with the aim of a prospective eye transplant.
During their conversation, Rodriguez cautioned Aaron that opting for a complete eye transplant, rather than solely a partial face transplant, might not result in restored vision. The successful functioning of the transplanted eye would rely on establishing a connection between it and the brain.
Nevertheless, Aaron expressed his willingness to proceed, stating, "Even if the transplant doesn't facilitate vision, I'll still have a functional eye with a normal appearance. Moreover, this experience could provide valuable insights for future cases. It's essential to have a pioneering patient."
Aaron's name appeared as a potential recipient in February 2023, and the chance for a whole-eye and partial facial transplant arose a few months later in May.
Rodriguez and his colleagues considered the operation "risky" as no medical team worldwide had achieved a successful human eye transplant on a living patient before.
"Its completely uncharted territory," Rodriguez said.
Dr. Eduardo Rodriguez, director of the Face Transplant Program at NYU Langone Health, performs the whole-eye and partial face transplantation surgery.
NYU Langone Health
The surgery required the use of two separate operating rooms. In one room, surgeons performed the procedure to extract the specific facial components of Aaron that were to be substituted with donor tissue. In the other room, Rodriguez meticulously dissected the donated face and eyeball.
"Approximately 12 hours were spent on this particular phase of the operation," Rodriguez disclosed.
"Now, it's crucial for me to make sure that Aarons room is fully prepared to accommodate the transplant," he shared. "We proceed by carefully cutting the blood vessels and separating the face from the donor. This marks the beginning of an intense process. At this stage, both the face and the eye are lacking a blood supply."
Subsequently, Rodriguez and his colleagues initiated the intricate process of connecting the donor face and eyeball to Aaron. To perform the eye transplant, the team integrated the donor eye with adult stem cells obtained from the donors bone marrow. This was achieved by injecting the adult stem cells directly into the optic nerve during the transplant procedure. The inclusion of these stem cells holds the potential to enhance nerve regeneration.
"We identified a specific adult stem cell called CD34, which has the potential to provide benefits in both immune modulation and neuroregeneration," Rodriguez explained. "During the whole-eye transplant surgery, we injected these CD34 stem cells at the site where the optic nerve connects between the donor and recipient."
Dr. José-Alain Sahel, clinical spokesperson for the American Academy of Ophthalmology, who has been involved in related experimental research but not in this procedure, emphasized that a crucial step in the surgery was the reconnection of Aaron's optic nerve to the donor eye. Sahel is also the chair of the Department of Ophthalmology at the University of Pittsburgh School of Medicine.
Sahel, who has been following the work of the NYU Langone Health team, praised their decision not to sever the optic nerve too far from the eyeball during the recipient's eye removal. However, he highlighted the need for further advancements in regrowing the optic nerve and guiding its fibers or axons to the right targets. He also emphasized the importance of preserving corneal nerves. According to Sahel, the success of this surgery suggests the potential for its effectiveness and encourages increased research and investment in corneal and optic nerve regeneration.
Aaron James sees his new face for the first time with Dr. Eduardo Rodriguez, wife Meagan and daughter Allie,
After the successful surgery, Aaron gazed at his newly transformed face in the mirror and felt an overwhelming sense of joy, as shared by Rodriguez. Ongoing monitoring is crucial for Aaron, and he must diligently adhere to a medication regimen to minimize the possibility of organ rejection. The medical experts closely observing Aaron's progress have observed encouraging indicators of a healthy eye, including proper blood circulation to the retina, which plays a vital role in visual processing.
Aaron, Meagan, and their high school graduate daughter, Allie, are eagerly anticipating their upcoming Thanksgiving celebration. Aaron, filled with anticipation, can already imagine the aroma and flavor of the Turkey Day feast. Additionally, he holds onto hope that one day, his donated eye will grant him the ability to see. "Whether or not he will regain his sight, that remains an unanswered question," stated Rodriguez.
"A transplant of this nature has never been undertaken before, and transplants operate in a distinctive manner, where unexpected events have even unfolded in face transplants, surpassing our initial expectations," he expressed. "Therefore, my optimism persists."
Join us to receive The Results Are In, a weekly show featuring Dr. Sanjay Gupta and the CNN Health team, every Tuesday. According to Dr. Oren Tepper, an email from plastic and reconstructive surgeon and director of the Craniofacial Surgery Program at Montefiore Health System, this procedure signifies a significant advancement in the field of transplant medicine.
Tepper, who was not involved in Aarons care, commented that this surgery is an impressive progress in the field of face transplantation.
If the transplantation of an eye is proven to effectively restore nerve function or visual signals, it would be a remarkable medical breakthrough for patients who have experienced eye loss as a result of trauma or cancer.
