This was almost one for the medical history books — a full face transplant and double hand transplant on the same patient.
Charla Nash, a Connecticut woman who lost her face and hands in early 2009 when she was attacked by an angry chimpanzee, is the patient.
She' received a full-face transplant at Brigham and Women's Hospital in Boston — only the third American to receive the operation. And while doctors have high hopes for her recovery, the other part of the surgery didn't go so well.
In a 20-hour operation, surgeon Bohdan Pomahac says the team transplanted hands from the same donor. But after the operation Nash suffered a blood infection that caused her blood pressure to crash. That compromised blood flow to the transplanted hands, so surgeons had to remove them.
"After several days of doing everything possible to retain the hands, it was clear that they were not thriving," Pomahac said at a press conference. "We're optimistic that should Charla choose in the future, we could transplant the hands again, should a suitable donor be identified."
Despite the loss of the hands, Pomahac says, "I consider it still a success" because Nash has a very good chance of regaining "a very functional face."
When the transplanted tissue heals and nerves regrow – a process that will take at least nine months and possibly longer – Pomahac says Nash "should control the face well. She could eat, smell, express her emotion and feel the face."
Nash is blind. Her eyes had to be removed after the attack.
The operation was performed in late May. Nash is still on and off a ventilator and sedated much of the time, although Pomahac says she is communicating through nods and arm gestures. She will need lifelong immune-suppressing drugs to prevent the donor tissue from being rejected.
Nash's brother Steve calls the transplant results "outstanding."
"It's amazing to see," he says. "It's like perfect. The functioning of the face will really add to the quality of her life."
Many people know of Nash because her injuries were so horrific – the angry chimp ripped off her face and gnawed her hands and forearm. A harrowing 911 recording from the chimp's owner, pleading with police to come and shoot the rampaging chimp, has been widely circulated. (You can listen here, but be warned, it's EXTREMELY disturbing.)
Following her initial restorative surgery at the Cleveland Clinic. Nash went on the Oprah Show and displayed her blank and mangled features.
But she's generally been loathe to go out in public without a veil. Pomahac notes that Nash did not attend her daughter Brianna's high school graduation last year because she didn't want to distract from the ceremonies.
"I think her new face will allow her to be present when Brianna graduates from college in a few years," he says. "It will be a great day for Charla and for all of us."
The Brigham and Women's team did its first full-face transplant in March on Dallas Wiens, a Texas man who went home from the hospital last month. A second full-face transplant followed in April on Mitch Hunter, an Indiana man.
The hospital has a grant from the Department of Defense to perform five face transplants.