When Robert Chelsea was driving on a motorway in California six years ago and realized that his automobile was overheating, he never could have anticipated that the life-altering trauma that would occur just seconds after he stopped his vehicle on the side of the road would occur just moments after he pulled over.
When a drunk motorist crashed into Chelsea’s car and disabled it, he was sitting in the driver’s seat at the time. Chelsea had just returned home from church. It erupted in flames, which led to an eruption of flames that scorched almost sixty percent of Chelsea’s body in addition to her face. Chelsea remained in a coma for a period of six months after she was rescued by a bystander and brought to a local hospital. She also stayed hospitalized for a period of one and a half years. During that period, he was in the operating room for almost 30 separate procedures. The injuries he sustained dramatically affected both his look and his physical function. Because of the severity of the scarring on his face, his lips, a portion of his nose, and his left ear were unable to be restored.
We strive excellence logoAfter becoming aware about face transplantation, Chelsea and his family began exploring the possibility with the expectation that he would be able to meet the requirements for one and eventually acquire one. In July, Chelsea, who was 68 at the time, made history by being the first black patient in the United States to have a complete face transplant. The surgery, which took place at the Brigham, was also the oldest one ever done in the country.
The face transplant operation, which lasted over 16 hours and included over 45 doctors, nurses, anesthesiologists, residents, and research fellows and was supervised by Bohdan Pomahac, MD, was the ninth of its kind to be performed at the Brigham and the 15th of its kind to be performed nationally.
“Despite being the oldest face transplant patient at the age of 68, Robert is progressing and recovering remarkably fast,” said Pomahac, who holds the Roberta and Stephen R. Weiner Distinguished Chair in Surgery at Brigham Health and is also the head of Plastic Surgery Transplantation there. We are hopeful that Robert will see a considerable rise in the overall quality of his life in the near future.
The Brigham has been acknowledged as one of the world’s leaders in transplantation for a very long time and was the first hospital in the United States to undertake a complete face transplant in 2011. Other important milestones for the hospital include performing the first successful transplant of a human organ donor kidney in 1954; doing the first heart transplant in New England in 1984; performing the first heart-lung transplant in Massachusetts in 1992; and performing the first bilateral hand transplant in New England in 2011.
In March of 2018, after being evaluated by Pomahac and going through an exhaustive screening procedure, Chelsea became qualified to have a face transplant. Because of the difficulty in finding a donor whose skin tone would be compatible with Chelsea’s, his wait for a donor was far longer than that of prior patients who had received face transplants at Brigham. This was made more difficult by the fact that the number of black organ and tissue donors is disproportionately lower than the number of white donors, and the range of skin tones among black donors is far bigger. The disparity is attributable to a number of factors; however, several studies have revealed that one of the primary factors is a widespread distrust of the medical system in the United States on the part of many black Americans. This distrust is a direct result of the prejudice that African-American patients have suffered throughout the history of the country.
A partial face transplant was performed on another black patient in Paris in 2007, and Chelsea is the first known patient of African descent to have a complete face transplant. The treatment that Chelsea got at the Brigham demonstrates the institution’s dedication to eradicating the health inequities that patients of color continue to experience throughout the country in the present day.
According to Alexandra Glazier, president and CEO of New England Donor Services, “it is critically essential for persons of all races and ethnicities to consider the donation of organs, including the donation of external grafts, such as face and hands.” [Citation needed] “It is vitally important for individuals of all races and ethnicities to consider the donation of organs. “Unlike internal organs, the skin tone of the donor may be important when it comes to finding a match.”
A follow-up study of face transplant recipient outcomes was recently published in The New England Journal of Medicine. The study found that the first patients to receive face transplants at Brigham and Women’s Hospital had a robust return of motor and sensory function of their face, as well as functionality. This allowed the patients to socially reintegrate in a way that would not have been possible prior to the transplant. According to these findings, Chelsea has a good chance of regaining almost normal feeling and around sixty percent of the function of her facial muscles within the next year. This would include the ability to eat, smile, and talk properly.
“Our previous experience has demonstrated that face transplantation is a viable option for patients with severe disfigurement and limited function who have no alternatives,” said Pomahac. “Our previous experience has demonstrated that face transplantation is a viable option for patients.” “As we continue to offer this treatment to an increasing number of patients, we are investigating various methods by which we can quantify the amount of benefit that is bestowed upon our patients. In addition, we are looking for opportunities to reduce the risks associated with this transplant by developing new immunosuppression protocols.”