Using 3-D Printing to Improve Face Transplantation

Posted by Brigham and Women's Hospital January 13, 2015

3-D models give physicians an opportunity to plan and test techniques before performing face transplant surgery.

Brigham and Women’s Hospital (BWH) is now using 3-D printing to help physicians prepare for face transplant surgeries and to help monitor the progress of their patients after face transplant surgery.

Dr. Frank J. Rybicki, Director of the BWH Applied Imaging Science Laboratory and Dr. E.J. Caterson from the Department of Surgery have developed 3-D models – before and after surgery – of the skeletal structures and the overlying soft tissue of two BWH face transplant recipients thus far. The precise 3-D models, which are based on CAT scan images, give physicians a more thorough, and tangible, representation of a face transplant recipient’s facial tissue.

“The tissues that are 3-D printed in one piece are much better than photographs,” says Caterson. “They provide a better understanding of a patient’s facial structure than any two-dimensional representation can.”

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Innovations in Organ and Tissue Transplantation

Posted by Brigham and Women's Hospital October 9, 2014

The face transplantation team worked for more than 20 hours to restore the face of Charla Nash.

In 2013, nearly 29,000 people received a second chance at life through the generosity of organ and tissue donors. Organ transplantation was made possible due to the pioneering work of Joseph E. Murray, MD, who performed the first successful human organ transplant in 1954 at Peter Bent Brigham Hospital, which later became Brigham and Women’s Hospital (BWH).

Dr. Murray received a Nobel Prize in 1990, in recognition of his contributions to the field of organ transplantation, including the development of immunosuppressive therapy to reduce organ rejection. Since that time, transplant specialists at BWH have achieved more firsts in organ transplantation in New England, including multiple organ transplants on the same day from an individual donor and multiple transplants on the same day from multiple donors.

Recently, BWH physicians achieved another transplant milestone by completing composite tissue allograft transplantation. This procedure allows surgeons to take something as complex as a face or arm and transplant it. In 2009, surgeons at BWH performed the first full face transplant in the U.S.

In this video, Michael J. Zinner, MD, Chairman, Department of Surgery, and Bohdan Pomahac, MD, Director, Center for Facial Restoration and Director, Burn Center, discuss transplant innovations at BWH over the past 60 years and the future of organ and tissue transplantation.

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Face Transplants – New Key to Managing Rejection?

Posted by Brigham and Women's Hospital February 5, 2014

This image of a rejection episode demonstrates significant activity by donor immune cells (red) and recipient immune cells (green).

Physicians and researchers commonly have believed that the key to ensuring the long-term success of a face transplant is to prevent the recipient’s T cells (immune cells) from attacking T cells in the donated tissue. Recent Brigham and Women’s Hospital (BWH) research, however, has shown that donor T cells transferred as part of the face transplant may attack recipient T cells and, thus, also contribute significantly to rejection episodes – not just the other way around.

The BWH Restorative Surgery team, led by Dr. Bohdan Pomahac, has had great success in pioneering face transplantation, but they also acknowledge that there is much to learn. Determining how a recipient accepts or rejects a donated face and how to address rejection episodes are considered to be among their most important challenges.

Following a face transplant, or any type of human organ/tissue transplant, T cells from the recipient mount an immune response to the donated tissue, threatening its survival. Thus far, rejection episodes following face transplants at BWH have been controlled successfully through immunosuppression medication, enabling all our recipients to maintain acceptance of their transplanted face.

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It’s a Wrap – Top Blog Posts in 2013

Posted by Brigham and Women's Hospital December 30, 2013

The blog team at Brigham and Women’s Hospital (BWH) is wrapping up 2013 with a selection of our most popular posts.  We’d also love to hear from you – what blog topics would you like to see in 2014?

We wish you a safe, happy New Year and thank you for your support.

 

Face Transplant Recipient Focuses on Her Gifts

Carmen Tarleton, got a new start on life when she became the fifth BWH patient to receive a face transplant. A team of more than 30 physicians, nurses, anesthesiologists and others worked for 15 hours to complete the surgery. Carmen’s story demonstrates how the generosity of neighbors, friends, and strangers can restore hope and healing.

 

Morning Heart Attacks: Blame It on Your Body Clock

Have you ever wondered why most heart attacks occur in the morning?  According to recent research from Brigham and Women’s Hospital and Oregon Health & Science University, you can probably place some of the blame on your body clock which drives day/night variations in a protein known to be a risk factor for heart attacks and ischemic strokes.

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Ringing out 2012 – Most Popular HealthHub Posts

Posted by Brigham and Women's Hospital January 1, 2013

The blog team at Brigham and Women’s Hospital would like to close out 2012 with a selection of our most popular posts.  We’d also love to read about your favorites in our comments section.

We wish you a safe and happy New Year and look forward to sharing more health stories with you in 2013.

 

1.  What’s in a Face?

After suffering a disfiguring injury, Dallas Wiens receives the gift of a new face – the first full face transplant in the U.S. – at Brigham and Women’s Hospital.  The life-giving surgery, performed by a team of more than 30 physicians, nurses, anesthesiologists, and residents , provides Wiens with the typical facial features and function of any other man.

 

2.  Prostate Cancer Screening – Should I or Shouldn’t I?

Dr. Anthony D’Amico, Professor and Chief of Genitourinary Radiation Oncology at Brigham and Women’s Hospital and Chief of the Prostate Cancer Radiation Oncology Service at Dana-Farber/Brigham and Women’s Cancer Center, discusses the benefits of prostate cancer screening, particularly for younger men.

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What’s in a Face?

Posted by Blog Administrator April 3, 2012

Dallas Wiens Before and After Face Transplant

Dallas Wiens before his injury; after the injury; soon after face transplant surgery; one year after the face transplant

Look at photos of Dallas Wiens over the past four years, and you’ll see a man of many faces.

The photo journey starts at age 23, with Wiens appearing handsome and healthy. Next, a horrific injury burns away all of his facial features – nose, lips, eyes – leaving his face scarred and vacant. Then, in spring 2011 at Brigham and Women’s Hospital (BWH), Wiens receives the gift of a new face – the first full face transplant in the U.S. – which provides him the typical facial features of any other man. Next stop, today – a year after the transplant – the swelling that is normal after any surgery has subsided and his nerve function has improved enough for him to smile and speak. He looks much like any other man you might see on the street.

To the casual observer, this multi-step transformation is obvious and stunning. But to Wiens’ now-5-year-old daughter Scarlette, her daddy always has been the same man. Wiens’ grandfather recounts that even after the burn left Dallas Wiens’ face featureless and blank, his daughter continued to crawl her way onto his lap, not in the least deterred by her father’s changed exterior.

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Know a Good Place to Get Sushi?

Posted by Blog Administrator March 2, 2012

Dr. Pomahac with face transplant patient Mitch Hunter

Dr. Bohdan Pomahac with face transplant patient Mitch Hunter

Anyone suffering from a long-term disease or debilitation yearns to return to or achieve a life of “normal” – including eating their favorite foods like sushi.

When meeting with a doctor or surgeon to review treatment, you discuss the technicalities – what incisions will be made, what medications will be taken, what follow-up care will be required. But the lingering question always is: When will I be better? When will life be “normal?”

Last spring, Dr. Bohdan Pomahac led teams of more than 30 doctors, nurses, anesthesiologists, and residents to complete three full face transplants. From a technical standpoint, the transplant is achieved when the blood vessels from the donor’s skin and the patient’s skin connect, and the color flows into the patient’s new face. But that is only the start. The face heals. The patient can smell again, can sneeze, and blow his or her nose. The patient has lips and can talk and eat. When out in public, the patient no longer confronts horrific stares.

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