New Beginnings
On the last day of April 2013, Marinda Righter (pictured above right) walked into Brigham and Women’s Hospital (BWH), for her first meeting with Carmen Blandin Tarleton (pictured above left), the recipient of her late mother’s face tissue. Both Righter and Tarleton were nervous, but once they met, it felt as if they had already known each other, they said. “I just walked over, and we hugged for a while and cried,” said Righter.
Tarleton added: “I couldn’t let go. It was an instant connection.”
Both shared their stories with local and national media during a May 1 press conference at BWH. Righter talked about the unwavering spirit of her mother, Cheryl, who died of a stroke, while Tarleton spoke about resiliency and starting a new chapter of her life after receiving the face transplant.
“I want others to know that they need not give up on healing themselves when tragedy strikes, but instead they can make a choice to find the good and allow that to help them heal,” said the 44-year-old Tarleton.
Righter said that her mom gave of herself to others and was a true example of living a selfless life.
“I believe that the universe conspired to bring these two women together,” she said. “They are both mothers, survivors, and beacons of light. I’m so honored that my mother’s journey here has ended in a way that allows you, Carmen, to continue your journey.”
In 2007, Tarleton, a registered nurse and mother of two from Vermont, was brutally attacked by her estranged husband, who doused her with industrial strength lye, burning more than 80 percent of her body.
Tarleton was rushed to BWH, where she was put into a medically-induced coma. During the course of several months, she underwent 38 surgeries. In the next five years, she had 17 additional surgeries, including some to restore her sight.
In February, Tarleton received a face transplant that included the nose, lips, facial muscles, arteries, nerves and neck tissue of a then-anonymous donor. Led by Plastic Surgery Transplantation Director Bohdan Pomahac, MD, her 30-person team worked for 15 hours to complete the transplant.
After two months post-transplant, Tarleton’s results were excellent, said Pomahac. During the press conference, Pomahac explained that unlike BWH’s four previous face transplant cases, Tarleton’s transplant covers more surface area and incorporates neck tissue as well.
“This has allowed more mobility for Carmen as she is now able to turn her head from side to side, and the pain in her neck has been relieved,” he said.
Added Tarleton: “Although I have been through what some may call hell, I found my way to my own happiness. I have faced each challenge—sometimes with my knees knocking—but I kept focused on what I wanted as an outcome.”
Behind the Science: A Body’s Acceptance
Doctors Conduct Tests and Treatments to Keep Rejection at Bay
Transplanting a face, let alone any body part, requires careful preparation to decrease the chances of the body rejecting the new part. In the case of Carmen Blandin Tarleton, doctors performed a sort of ‘litmus test’ before her face transplant to see whether her immune system would accept the new face. The test was done by mixing samples from Tarleton’s blood with cells from the face transplant donor.
It’s Positive
Tarleton tested positive, as doctors had suspected. This meant that Tarleton had various antibodies in her blood likely to attack donor tissue, making it difficult to find an acceptable donor match. In spite of this, Tarleton and her care team accepted the risk and moved forward with a face transplant that would be backed by a salvage procedure that could be done in case Tarleton’s body rejected the transplant.
Treating Rejection
Prior to the surgery, doctors filtered Tarleton’s blood to remove any antibodies that may reject the transplant. However, after the surgery, Tarleton’s body did show signs of transplant rejection. But doctors were able to suppress the rejection response with medications, as well as prevent future rejection responses.
Although, there is still a risk for future rejection episodes, Tarleton continues to take medications to keep her antibodies from rejecting the transplant, and the treatment has been successful.
