A surgical team from NYU Langone Health in the US has performed the world’s first human whole-eye transplant, with encouraging early signs.
The landmark surgery, performed on Mr Aaron James, a 46-year-old military veteran from Arkansas who survived a work-related high-voltage electrical accident, involved transplantation of the left eye and a portion of the face from a single donor. It is reported to be the only successful combined transplant of its kind in medical history.
Since the May 2023 procedure, the transplanted left eye has shown “remarkable signs of health”, including direct blood flow to the retina. Although it is unknown whether James will regain sight in his eye, the surgery is a major milestone for potential vision therapies.
The surgery, led by Dr Eduardo Rodriguez, lasted approximately 21 hours, and included a team of more than 140 surgeons, nurses and other healthcare professionals.
“Aaron has been extremely motivated to regain the function and independence he lost after his injury. We couldn’t have asked for a more perfect patient,” Rodriguez said.
“We owe much of our success in this monumental endeavour to the exceptional institutional support we receive at NYU Langone and the unwavering dedication of our world-class team in delivering the highest level of care to our patient. This achievement demonstrates our capacity to embrace the most difficult challenges and drive continuous advancements in the field of transplantation and beyond.”
As a result of his injury in June 2022, James lost his dominant left arm from above the elbow, his entire nose and lips, front teeth, left cheek area, chin down to the bone and surgeons were forced to remove his left eye due to severe pain.
Surgeons preserved as much optic nerve length as possible to maximise future reconstructive options.
NYU Langone’s multidisciplinary team, Rodriguez, and the James family collectively made the decision to move ahead with a whole-eye transplant in combination with the face, understanding that at it may only provide cosmetic benefits.
“Given James needed a face transplant and will be taking immunosuppressive drugs regardless, the risk versus reward ratio of transplanting the eye was very low. Despite the eye being successfully transplanted, from a cosmetic standpoint, it would still be a remarkable achievement,”Rodriguez said.
He added: “The mere fact that we’ve accomplished the first successful whole-eye transplant with a face is a tremendous feat many have long thought was not possible. We’ve made one major step forward and have paved the way for the next chapter to restore vision.”
Rodriguez and the team at NYU Langone’s Transplantation and Cellular Therapy Center combined the donor eye with donor bone marrow-derived adult stem cells injected at the optic nerve connection of the recipient to replace the damaged or dysfunctional elements.
James will continue to have various clinical tests on the left transplanted eye, including electroretinography, to measure any indications towards sight restoration.
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