Zespół chirurgów z NYU Langone Health dokonał pierwszego na świecie przeszczepu twarzy i obu dłoni od jednego dawcy. Operację przeszedł 22-letni mieszkaniec New Jersey, który został poważnie poparzony w wypadku samochodowym. Zabieg przebiegł pomyślnie.
Operacja odbyła się w sierpniu ubiegłego roku. Zabieg z udziałem 140 specjalistów, nadzorowanych przez dr. Edwarda D. Rodrigueza z NYU Langone Health, trwał 23 godziny. Specjaliści z NYU jako pierwsi na świecie dokonali jednoczesnego przeszczepu twarzy oraz obu dłoni od jednego dawcy. Wcześniej podjęto dwie podobne próby, jednak pierwsza zakończyła się śmiercią pacjenta ze względu na powikłania infekcyjne, a druga – amputacją przeszczepionych dłoni.
Jednoczesny przeszczep twarzy i dłoni
Operację przeprowadzało jednocześnie 6 zespołów specjalistów. Każda grupa przydzielona była oddzielnie do twarzy lub jednej ręki zarówno u dawcy, jak i biorcy.
– W ciągu roku przećwiczyliśmy operację prawie kilkanaście razy. Na salach operacyjnych pracowały zespoły, które dbały o to, by wszyscy dokładnie wykonywali poszczególne kroki, nie pomijając żadnego kroku i nie wychodząc poza kolejność. Ostatecznie sama operacja przebiegła znacznie sprawniej, niż się spodziewałem – wskazuje dr Rodriguez.
Podczas zabiegu zespoły pracowały zgodnie z ustalonym wcześniej harmonogramem. Specjaliści dokonali następujących przeszczepów: obu rąk do połowy przedramienia, kości promieniowej i łokciowej, 3 nerwów dominujących w dłoniach, 6 naczyń krwionośnych i 21 ścięgien twarzy, czoła, brwi, uszu, nosa, powiek, wargi, oraz skóry czaszki, policzka i podbródka.
Zabieg okazał się sukcesem. Po operacji pacjent miał stale monitorowany układ odpornościowy. Wdrożono indywidualnie dopasowaną terapię immunosupresyjną. Nie zaobserwowano epizodów odrzucenia przeszczepów u 22-latka. Pacjent spędził kilka tygodni w oddziale intensywnej terapii, a następnie kontynuował powrót do zdrowia w oddziale rehabilitacyjnym. Dwa miesiące po zabiegu został wypisany do domu.
Zdj. Nadzorujący przeszczep dr Edward D. Rodriguez oraz Joe DiMeo, 22-latek, który poddał się operacji. Źródło: NYU Langone Health
6 proc. szans na znalezienie dawcy
Joe DiMeo, 22-latek, który poddał się operacji, miał jedynie 6 proc. szans na znalezienie dawcy. Ze względu na wcześniejsze transfuzje krwi, jego układ odpornościowy był silnie osłabiony. Ponadto dawcę należało również dopasować pod względem struktury kości czy odcienia skóry. DiMeo widniał na liście biorców przez 10 miesięcy, a operację udało się wykonać 2 lata po wypadku.
– Znalezienie Joe idealnego dawcy było jak znalezienie igły w stogu siana – podkreślał dr. Rodriguez.
Zespołowi z NYU udało się jednak znaleźć dawcę dzięki programowi dawców Gift of Life.
80 proc. poparzenia ciała
W lipcu 2018 r. mężczyzna zasnął za kierownicą pojazdu i spowodował wypadek samochodowy. Doznał oparzeń 3. stopnia, które obejmowały 80 proc. powierzchni ciała. 22-latek doświadczył deformacji twarzy, nie miał warg, ani powiek. Został wprowadzony w stan śpiączki farmakologicznej, z której wybudzono go po kilku miesiącach. Wykonano u niego ponad 20 operacji rekonstrukcyjnych. Jednak rozległe blizny twarzy iobu dłoni nie pozwalały mu prawidłowo funkcjonować. Podjęto wówczas decyzję o znalezieniu dawcy twarzy i dłoni.
Źródła: NYU Langone Healt
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