The first black face transplant in the black patient has been successful
WEDNESDAY, March 17, 2021 (HealthDay News) – Robert Chels needed a new face, as he lost many years ago in a horrific traffic accident in Los Angeles.
Chelsea are black, and the first face transplant process posed new challenges for their doctors, according to a new report.
Doctors said Chelsea needed four times more than normal for white patients to be a suitable donor, due to a lack of donors and a greater variability in skin tone among black Americans.
“It’s very rare to find a black face [for transplant]”He said in an interview with Chelsea BBC. “We didn’t know how weird it was.”
In addition, the follow-up to Chelsea’s post-surgery progress was more complex due to the dark skin tone. Doctors have the ability to see redness as an early sign of rejection, said chief surgeon Bohdan Pomahac, the director of plastic surgery transplant. At Brigham and Women’s Hospital in Boston.
“In the case of a white patient, you can see redness as a sign of infection or a sign of rejection. It can’t really be said in African-American patients,” Pomahace said. “The redness is very subtle, if you can detect it.”
In August 2013, a car for disabled people in Chelsea was hit by a drunk driver on the LA highway, so forcefully that the vehicle exploded.
Chelsea had burns of more than 60% of her body and face. He lost his lips, part of his nose and part of his ears, and needed more than 40 surgeries to regain his health.
Doctors advised Chelsea to perform a face transplant, which was included in the list of transplants.
“Being able to address a person without fear would be a great relief,” Chelsea said BBC before surgery.
However, it was not easy to find the right donor.
Chelsea spent nine months on the list before receiving a first offer from a donor, and it was on the list for a total of 17 months before surgery, doctors reported on March 18. New England Journal of Medicine. The average time it takes to find a donor for a white patient on the list is four months.
One problem was the lack of donors. “The number of African American donors is extremely low,” Pomahace said.
Proper skin tone
Pomahac said another problem was finding the right match for skin tone. In the case of a black patient it can range from almost dark blue to dark capuchin.
Pomahac said “there is a lot of range of different colors, it looks very disturbing.”
Chelsea denied two donors before finding one that they considered compatible. Pomahac said other donors were also not presented as an option to Chelsea because they were very unsuitable from the start.
Skin tone also underwent surgery to the last extent. Chelsea only needed a partial face transplant, but we finally decided to do a full face because I was worried that the face would be abnormal with “two different skin tones,” Pomahace said.
In July 2019, Chelsea, then 68 years old, became the first black American to receive a face transplant and the first in a 16-hour surgical procedure consisting of 45 medical professionals from Brigham and Women’s Hospital.
The world’s first partial face transplant was performed in France in 2005, and the first full face transplant was completed in Spain in 2010, with only about 40 such surgeries performed, all in white patients before Chelsea.
The operation was a success, but in the following days Pomahac and his team encountered another problem, trying to see if Chelsea’s body would accept or reject the transplant.
In the case of white patients, it’s a clear sign of rejection of skin redness, because “we feel like we can control rejection in real time, roughly,” Pomahace said.
Such redness is more difficult to see on the skin of a black patient, so doctors regularly added an inspection and biopsies of Chelsea’s mucous membranes – the inside of the cheek, the lip liner – as a way to track the rejection.
Deep need to donate organs
Chelsea’s transplant has been shown to be successful, but its testing has clarified the need to promote organ donation among blacks and other ethnic groups.
“It is very important for individuals of all races and ethnicities to consider organ donation, providing external inserts such as the face and hands,” Alexandra Glazier, president and CEO of New England Donor Services, said in a statement. “Unlike internal organs, the donor’s skin tone can be important to match.”
“God bless the donor who decided to give this precious gift and gave me his family and a second chance,” Chelsea said after the operation. “Words can’t describe my feeling. I’m overwhelmed with gratitude and I feel so happy to receive such an amazing gift.”
Black patients should take hope in the case of Chelsea, and if they need similar operations they should go to the doctors, Pomahace said.
“It’s important to make sure that African Americans and people of any color are here regardless of their background, and that we are able to help,” Pomahace said.
Brigham and Women’s Hospital has more to offer Robert Chelsea’s face transplant.
SOURCES: Bohdan Pomahac, MD, director, plastic surgery transplant, Brigham and Women’s Hospital, Boston; New England Journal of Medicine, March 18, 2021; BBC