Poland's 1st face transplant patient goes home (Update 2)July 30, 2013 by Monika Scislowska in Medicine & Health / Surgery
Poland's first face transplant patient was discharged from the hospital Tuesday, speaking with some effort at a press conference just 11 weeks after the extensive surgery that saved his life.
The 33-year-old man said he owes his doctors "everything" following a skin-and-bone transplant on May 15, three weeks after losing his nose, upper jaw and cheeks in an accident at the brick factory where he worked. Doctors say it was the world's fastest time frame for such an operation.
In a later television interview, the man said he feels "fabulous."
Doctors who performed the transplant at the Cancer Center and Institute of Oncology in Gliwice, in southern Poland, said the rehabilitation is proceeding faster than expected thanks to the "courage and determination" of the patient, identified only as Grzegorz.
He can breathe on his own, see, eat, taste and speak, although his speech is hard to understand because the face muscles still need to regain mobility. He has the sensation of pins and needles in his cheeks, which is a sign of the severed nerves healing, doctors said.
When muscle mobility is achieved through intensive exercise, he will need surgery on his right eyelid, which remains motionless. At the news conference, his eyes were hidden behind sunglasses.
A pressure sore, originating from time Grzegorz spent at another hospital, still needs to heal, doctors said.
The surgery reconstructed the area around the eyes, nose, jaw and palate and other facial areas, with the transplant running from above his right eye, under his left eye and around his face to his neck.
He will need to avoid large gatherings and sick people to protect against infection. He will take medication for the rest of his life, the anesthesiologist, Dr. Sebastian Giebel, told the news conference. Potted plants, rugs and the man's dog had to be removed from his home because they were potential sources of infection, he said.
Grzegorz will be able to resume work, though he will have to avoid working in agriculture, where he could catch fungi or other infections from the soil, said Dr. Adam Maciejewski, who led the 27-hour operation. Maciejewski estimated the costs of the surgery at some 220,000 zlotys ($ 70,000), not including the pay for the surgical team. The costs are covered by Poland's national health service.
The patient's mother was making roast duck for his homecoming, said his sister, who identified herself only as Barbara.
"We will see what comes next, but we are and will be with him," she said.
The patient took the microphone to thank his doctors. "My speech isn't clear, but it's really important that it is there," he said. "I know it's still a long way." His words were transcribed in a broadcast by TVN24 after the press conference.
In an interview aired later on TVN24 he said he remembered the accident, in which he did not lose consciousness, and remembered how colleagues led him to a helicopter ambulance.
"I did not feel pain," he said. "I did not feel that I lost my face."
He said he was aware that he would look different after the surgery, so when he saw his new face in the mirror "it was a truly cool thing for me, because I was aware that it could have been unsuccessful. I knew how badly maimed my face was. "
He was injured on April 23 at a concrete brick factory near the southwestern city of Wroclaw, while cleaning a packaging machine. It tore off most of his face, including the upper jaw.
He received intensive treatment at a hospital in Wroclaw that saved his life and eyesight. An attempt to reattach his own face failed, leaving an area close to the brain exposed to infections.
The damage was too extensive for doctors to temporarily seal the wound, and an urgent transplant was considered the only way to save the man's life.
Face transplants are extraordinarily complicated and relatively rare procedures that usually require extensive preparation of the recipient over a period of months or years, but the Polish patient's condition was deteriorating so rapidly that the doctors had to act fast. They have experience in face reconstruction from operating on cancer patients and practicing on cadavers.
The donor, a 34-year-old man, was chosen from a national registry of potential donors after his age, gender, blood group and body features were determined to be a good match for the injured man.
The donor's mother, Teresa Banach, has said it was a "difficult decision, but I consented because I wanted to save someone's life. My son did not need these organs anymore." She also donated organs to other patients.
Grzegorz said he was sorry that Teresa Banach lost her son—whose name was not released—and feels a bit "strange to have received his face." But he added that he is also full of "gratitude and respect" for her decision.
He said that the support of his own family has given him strength to carry on.
More than two dozen transplants of the face or parts of the face have been performed around the world. The first one was a partial face transplant on a woman maimed by her dog in France in 2005.
© 2013 The Associated Press. All rights reserved.
"Poland's 1st face transplant patient goes home (Update 2)" July 30, 2013 http://medicalxpress.com/news/2013-07-poland-transplant-patient-home.html