A multidisciplinary team of Vall d'Hebron University Hospital, led by Dr. Joan-Pere Barret, head of Plastic Surgery and Burns, made a successful face transplant to reconstruct two thirds of his lower face, neck, mouth, tongue and pharynx of a patient who has been affected by a massive arteriovenous malformation for 20 years. The disease has caused a progressive deformation of the tissues. The patient, due to the evolution of his illness, had important functional alterations, such a vision problems, speech and risk of severe bleeding that put his life at risk. This is the first time that a transplant of this complexity is performed in the world.

The patient had been examined in several international hospitals (Mayo Clinic, Harvard, etc.) where he was considered inoperable. The evolution of the disease, a progressive deformity and severe bleeding that had put his life at risk, was assessed by the face transplant team of Vall d'Hebron, which considered that the only treatment option for this patient was removing his tumour tissues and rebuilding his face through a face transplant.

The operation, carried out in early February, was highly complex and lasted 27 hours. The team comprised 45 professionals from different departments of the Hospital: Plastic Surgery, Anaesthesia, Nursing, Nursing Assistants, Liver Transplant, Transplant Coordinator, Infectious Diseases, Interventional Neuroradiology, Intensive Care Unit, orderlies and all central and support services.

The patient evolution after the surgery was successful, similar to any transplanted patient in the hospital. Now he is already at home and only comes to the Hospital to do routine checkups. During the weeks after the transplant, has been doing rehabilitation treatment and the required immunosuppressant regimen has been adjusted. At this stage the nurses and nursing assistants in the Burn Unit, the Department of Rehabilitation, Physiotherapy and Occupational Therapy, Dietetics and Nutrition Departments, the Department of Psychiatry and Social Services of the Hospital all have played an important role.

This is the second face transplant carried out in the Vall d'Hebron Hospital. The first, which was the first full face transplant in the world, was in April 2010. It was performed to Oscar, a young man who suffered a severe deformity in his face caused by a trauma that had left him without nose and nostrils, and had deformed his upper and lower jaw, cheekbones, his ethmoid bone area, lips, mouth and soft tissues of his face. This caused him serious functional problems, since he had difficulty breathing, speaking, swallowing and had to be fed artificially. The patient is currently living a normal life. All the skin and muscles of his face, nose, lips, jaw, all teeth, palate and cheek bones were transplanted by using plastic surgery techniques and vascular-nervous microsurgery

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