US doctors have successfully performed the world’s first skull-scalp transplant on a Texan
James Boysen, a 55 year-old software engineer from Texas became the first person to undergo a skull and scalp transplant and doctors say the successful operation has given him “a new lease on life”. It was a 15-hour operation and he was undergone the procedure as part of his recovery from cancer, which had left the top half of his head severely damaged.
On 22nd May, the craniofacial tissue transplant was carried out at the same time as a kidney and pancreas transplant at Houston Methodist hospital. All of the organs, tissue and bone came from the same donor to give the operation the best chance of success. There were more than 50 healthcare professionals involved in planning the surgery, which had been in the pipeline for two years. According to media, Boysen said “I’m amazed at how great I feel and am forever grateful that I have another chance to get back to doing the things I love and be with the people I love.
Michael Klebuc, plastic surgeon at the Houston Methodist Hospital, explained to the Associated Press that “This is a microsurgical procedure and in order to get the bone and the scalp tissue to survive in the new location, you have to connect blood vessels under a microscope with little stitches about half the diameter of a human hair.” Last year, doctors in the Netherlands said they replaced most of a woman’s skull with a 3-D printed plastic one. The Texas operation is thought to be the first skull-scalp transplant from a human donor, as opposed to an artificial implant or a simple bone graft.
Boysen had a kidney-pancreas transplant in 1992 to treat diabetes he has had since he was 5, and he has been on drugs to prevent organ rejection. The immune suppression drugs raise the risk of cancer, and he developed a rare type of disease called “leiomyosarcoma”. It can affect many types of smooth muscles, but in his case, it was the ones under the scalp that make your hair stand on end when something gives you the creeps. The medical team stated that they only considered the unprecedented skull and scalp procedure because Boysen was already undergoing another pair of transplants and would therefore already be taking the drugs that would help his body accept the newly added organs.
Radiation therapy for the cancer destroyed part of his head, immunosuppressive drugs kept his body from repairing the damage and his transplanted organs were starting to fail — “a perfect storm that made the wound not heal,” Boysen said. The recipient Jame Boysen expects to leave the hospital with a new kidney and pancreas, along with the scalp and skull grafts. He said he was stunned at how well doctors matched him to a donor with similar skin and hair color. “It’s kind of shocking, really, how good they got it. I will have way more hair than when I was 21,” Boysen joked.
Houston Methodist, which has transplant expertise, partnered in the venture. It took 18 months for the organ-procurement organization, LifeGift, to find the right donor, who provided all organs for Boysen and was not identified. Boysen was given a cap-shaped, 10-by-10-inch skull graft, and a 15-inch-wide scalp graft starting above his forehead, extending across the top of his head and over its crown. It ends an inch above one ear and 2 inches above the other. Any surgery around the brain is difficult, and this one required a very complicated work to remove and replace a large part of the skull and re-establish a blood supply to keep the transplant viable.
“It’s a very ingenious solution” to the patient’s problems, said one independent expert, Dr. Bohdan Pomahac, a reconstructive surgeon at Harvard-affiliated Brigham and Women’s Hospital in Boston. His hospital has done seven face transplants and three double-hand transplants and has plans to do arm and leg ones in the future.
