Face Transplants and Beyond

Face Transplants and Beyond

When the late Joseph E. Murray, MD, walked into a Brigham operating room in 1954 to attempt the first kidney transplant, he knew the world was watching. Similarly, in 2009, when Bohdan Pomahac, MD, scrubbed in to perform one of the first face transplants, the world watched; that time, cameras captured the swirl of activity.

Pomahac has since gained international attention by performing a number of face and hand transplants, including the first full face transplant in the United States in 2011. But on the day of that first operation on Dallas Wiens (pictured with Pomahac above), Pomahac was a relatively unknown surgeon with a big goal. “French surgeon Dr. Jean-Michel ‘Max’ Dubernard had performed the world’s first successful partial face transplant, and I knew this procedure could help one of my patients,” says Pomahac. “There were ethical debates, but Dr. Murray was highly supportive of what I was trying to do.”

Pomahac recalls important advice. “Before that first operation, I wondered if I had done as much as I could to prepare. Dr. Murray said, ‘That feeling that you can be better prepared will never pass. You’re ready. If you over-think it, it won’t happen.’”

Before he died in November of 2012, Murray was especially fascinated by the series of face and hand transplants at BWH. “When we were starting in the field after World War II, we never dreamed transplantation would expand so much,” he said. “The Brigham has played a key role.”

Murray believed that Dr. Max Dubernard, the French face transplantation surgeon who had been a research fellow at BWH and Harvard Medical School in 1965, had benefited from training at BWH that emphasized innovation. “The spirit of the Brigham has always been ‘How can we do things better?’” said Murray. “We also used to comment, ‘If we don’t do it, who will?’”

Pomahac sees parallels going forward. “In the 1950s, it took hard work and 10 dark years to develop immunosuppressive medication,” he notes. “Dr. Murray and his colleagues persevered and ultimately opened the gates to organ transplant. We believe if we can, once again, tweak the immune system and achieve better immune suppression, the transplant of faces, hands, legs, and other organs could become more common. It could really open the door to the replacement of any body part. And it could be historically similar.”

“Brigham and Women’s Hospital is where the next step in transplantation should take place,” adds Stefan G. Tullius, MD, chief of transplant surgery at BWH, co-director of the Schuster Transplant Center, director of the Transplant Surgery Research Laboratory, and designer of the anti-rejection protocol for all face transplants. “We take an individualized, multidisciplinary approach. So we’re positioned to remain a pioneering facial and extremity transplant center."