This July marks 4 years since the media reported that the first complete face transplant in the world had been successfully completed in Barcelona. Oscar, the patient, and Dr. Joan Pere Barret made history and filled the front pages. Four years after the news broke, the operation was performed a few months earlier, Dr. Joan Pere Barret -member of Top Doctors- answers in this interview about the current situation of the patient but also how they prepared and the feelings they had before and during the intervention.
More than four years have passed since Oscar’s operation, the first complete face transplant in the world, how has the patient evolved? During these 4 years the patient’s evolution has been excellent. This type of patient follows a course similar to that of any transplant recipient. They have to be monitored periodically, adjusting medications according to individual needs. The aim of face transplantation is to restore lost functions and facilitate the psychosocial reintegration of the patients.
The face transplant has allowed Óscar to recover his daily activities, being able to do again those little things that we all do every day and that characterize us as human beings. In this sense, the transplant has given him back his life.
Is it the most complicated operation you have ever done? Let’s try to remember the most important facts: what was the patient’s starting point, what did he need, how many doctors worked on the operation and for how many hours?
Face transplantation is the most complex surgical intervention that exists. The complete face transplant (and Oscar’s was the first in the world) is a high-risk surgery, totally complex and within the reach of very few surgeons and centers.
The patient always starts from a very compromised situation, with destroyed anatomy and very important functional deficits. Oscar needed a complete face transplant, not only of the external part of the face, but also of the facial bones and the internal part of the mouth, including the palate and teeth.
The transplant lasted 24 hours, although the team was activated many hours before, assessing the donor and preparing the operating room and the patient. More than 30 professionals were involved, including surgeons, nurses, transplant professionals, anesthesiologists… etc.
If you were to encounter a case like this again today, would you do anything differently? Has the technique evolved?
Medicine is a continuously evolving science. The results of all the procedures we apply are evaluated over time in order to increase the quality and excellence of the results. We are always critically analyzing our techniques and treatments in order to develop new advances and innovations. Currently, we have increased the radiological and 3D simulation evaluation in craniofacial reconstructions, in order to maximize tissue matching between donors and recipients. We have also enhanced the vascular analysis of tissues and the anatomy of patients who are candidates for transplantation. The aim is to know 100% of the anatomical and vascular situation of the recipient patient, in order to facilitate surgery at the time of transplantation.
How do you personally remember this case? What surprised you most about the way the patient experienced the process?
We prepared the transplant and the whole process, including the creation of the team that was going to perform, for many months. The surgery was also rehearsed in the dissection room of Anatomy (UAB) to avoid any error during the transplant.
In this sense, although it was the first time it was performed in the world, we were prepared.
However, the responsibility of what we were about to perform was immense. In our hands was Oscar’s life and respect for the donor: failure was not an option. Also, the hospital and the entire Catalan healthcare system rested squarely on my shoulders. Success shines on everyone, but failure is individual.
Oscar is the ideal patient. His confidence was and is absolute. On the most crucial day of his life, his calmness infected the whole team and his response to the transplant was extraordinary. When he wanted to see his new face and we provided him with a mirror, his eyes spoke for him: the nightmare was over.