Seventy-two hundred volts of electricity went through his body and hurt his left eye and a lot of the arm that he brought up to protect it. He was also burned all the way through on his nose, lips, mouth, and chin.
The soldier from Hot Springs, Arkansas, was badly hurt and couldn’t smell, taste, or eat solid things.
He got the new eye from the same donor as the rest of his face, but it’s not clear yet if it will ever let him see. For now, it looks healthy. The team hoped that the transplant would make the person look better and that the eye would work.
Thursday was the first time that James and his doctors told the world about his story. He was hurt, he had a donor, and people were working to get him back to a normal life.
James said that the surgery made him feel better about himself again.
“Since the transplant, I tell people I can’t walk past a mirror without looking at it,” James told the media. “It has made me stand taller.” Five months after surgery, James is still healing well, according to the process’s leader, Dr. Eduardo Rodriguez, who is in charge of the Face Transplant Program and the Hansjorg Wyss Department of Plastic Surgery at NYU Langone.
He still can’t see out of the new eye, and he might never be able to. But he can eat, smell, and taste properly again, and he is no longer hooked up to tubes or machines.
At 9:14 a.m. on May 27, the surgery began. It ended 21 hours later at 7:51 a.m. on May 28, during the Labor Day weekend. A 14-person medical team worked in two operating rooms, and there were 15 full-scale practices over the course of three months. To help the team understand what they needed to do, 3D-printed copies of James’ body were used.
Rodriguez said that the team’s success was due to months of hard work and planning, as well as James’s attitude and the constant support of his family.
“You won’t be able to hold Aaron down. Rodriguez said, “He fights.”
There are big risks involved
Rodriguez did his first face transplant in 2012 and said he carefully chooses prospects because the process is dangerous and the mental toll of this kind of injury and recovery is very high. He can’t promise that they will live through the surgery or for how long.
“I tell these people, ‘You will probably live for 10 years.'” “Should I take the chance?” Rodriguez said, adding that it is known for donation drugs to damage organs in ways that make them less useful for life. He did say that the first patient from 2012 is still doing well, so “we don’t know the exact timeline or longevity of face transplants.”
People used to think that eye transplants were too dangerous because of the medicines needed, the chance that the graft could lead to a brain infection, and the low chance of success.
Rodriguez said that there wasn’t much extra risk in adding the eye since James would still need the medicine to protect his new face even if it didn’t work.
At first, everyone thought that the donor eye would just help James look more like himself again. However, Rodriguez said that as the doctors thought about his case, they hoped that they might also be able to make it work again.
Eye transplants have been thought to be too hard in the past because of the risk of immune rejection and the need for the new eye to grow nerves and blood flow to the retina.
So far, the results have been “incredibly surprising” and better than they expected, he said. “We’ve got an eye that’s alive and an eye connected to the optic nerve, which is a direct connection to the brain.”
James got his first medical care after the accident in Texas, but the NYU team got involved early enough that when his eye was taken out, they suggested cutting the optic nerve as close to the eyeball as possible to keep the nerve’s length and give doctors the best chance of reconstructing it later.
It’s still possible that the optic nerve in James’ new eye could join to his brain and start sending messages. This is because nerves grow slowly. Doctors said they don’t know when or if the surgery will happen because it is so new.
An ophthalmologist who led that part of the surgery, Dr. Vaidehi Dedania, said at the news conference that the eye is healthy because blood is flowing to the new retina. The retina is the part at the back of the eye that gets light and sends pictures to the brain. She also said the cornea is linked and looks fine.
“Going into this case, I was hopeful that the eye would live at most 90 days,” said Dr. Bruce Gelb, vice chair of quality in surgery at the NYU Langone Transplant Institute and a transplant surgeon. “But the fact that we have a real cornea and a retina with good blood flow after five months, I think we’ve already hit a home run.”
“That’s the top of the range, and any more recovery from the eye will be surprising and exciting to see,” he said. “It looks like we’re seeing a supernova.” We will keep an eye on things and learn more over time.
The donated eye is brown, and James has blue eyes. He still can’t move the eyelid over the new eye, but he can now squint, which other people who have had face transplants haven’t been able to do.
He said it doesn’t bother him at all that his eyes are different colors: “It could be pink and I wouldn’t care.”
Rodriguez said the progress made so far is a “total game changer,” even if he can never see out of that eye.
In the past, doctors could restore nerves in the so-called peripheral nervous system, which includes the face and limbs, but not in the central nervous system. This is why spinal cord injuries were thought to be permanent.
Rodriguez said that the success with James changes that idea.
“We’ve crossed into the frontier of the central nervous system,” he stated. “I think the options are limitless.”
Depending on someone else’s kindness
President and CEO of LiveOnNY, Leonard Achan, said that the donor was a guy in his 30s from a family that strongly supports organ donation. LiveOnNY led the search for a donor for James.
The man’s name and reason of death have not been released. He also gave his kidneys, liver, and pancreas, which saved the lives of three people between the ages of 20 and 70, Achan said in a statement.
James got the donor’s nose tissue, left upper and lower eyelids, eyebrow, upper and lower lips, skull, cheek, nasal and chin bone segments, and tissues below the right eye, which included muscles, blood vessels, and nerves. The donor also gave James the whole left eye and eye socket.
James also has a beard that comes from the giver.
He also got cells from the donor’s bone marrow, which were taken from the man’s groin. Doctors hope that these cells will help James’ optic nerve heal and connect to the donor eye.
After the transfer, the dead man’s face was changed with a copy made from 3D printing. Rodriguez said that this let the donor’s family follow their customary ways of burying people.
James has never met the donor family, but he wants to do so one day.
When Rodriguez met the family, he said they were “incredibly kind and generous,” and he said, “They didn’t hesitate at all to help out Aaron and other patients whose lives they changed.”
Moving on with Life
James is a soldier of the Army who did three tours of duty in the Middle East. He said he has no memory of the accident that almost killed him or of that day in general.
Since then, everything has changed.
Even though it “sucked,” it made him very thankful for his family and friends who have been there for him. It had been 20 years since he and Meagan got married, but she wouldn’t accept his offer. “”No, we’re in this until the end,” she said.
James said he’s not thinking too far ahead right now because he’s focused on getting better.
“Thank God for the next day after getting through the last one.” “Right now that’s all you can do,” he told her. “I no longer wish to worry about too far into the future.” The piece of paper that says, “You’ll live to be 80 years old,” is not what we want.
Rodriguez said he was nervous the day he showed James his new face for the first time, but he was thrilled by how he reacted. “It was very difficult to have a dry eye in that room.”
The doctor was impressed with how hard James and his family worked to help him get better.
“As long as he takes care of that face, I think he will have a great life moving forward,” said Rodriguez.
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