Doctors at New York University’s Langone Health have completed the very first successful face and double hand transplant, a historic first. “We’ve succeeded in a tremendous undertaking that shows we can continue to take on new challenges and advance the field of transplantation,” Dr Eduardo D Rodriguez, who has led at least four face transplant surgeries, told NBC’s The Today Show. Joe DiMeo, a nightshift worker from New Jersey underwent a 23-hour surgery in August after suffering third-degree burns over 80% of his body in a July 2018 car accident, in which he had fallen asleep at the wheel commuting home from work on a night shift. Following his vehicle’s explosion, DiMeo was hospitalized for more than four months in the burns unit of a New Jersey hospital, including over two months in a medically induced coma. His fingertips had been amputated, face severely scarred, and lips and eyelids removed. The surgeries diminished his vision, mobility and quality of life. After nearly two dozen reconstructive surgeries, DiMeo remained on the donor registry for 10 months before finding a donor for the face transplant. The donor was transferred to NYU Langone on 10 August, and DiMeo was in the operating room just two days later. “This is a once-in-a-lifetime gift, and I hope the family can take some comfort knowing that part of the donor lives on with me,” DiMeo said. “My parents and I are very grateful that I’ve been given this second chance.” The coronavirus pandemic threatened the 22-year-old’s surgery, partly because organ donations had plummeted in the first months. Many members of DiMeo’s transplant team were also temporarily reassigned to work in emergency and pandemic response units. Still, Rodriguez noted that doctors “practiced the surgery nearly a dozen times over the course of a year”. “In the [operating room] we had teams ensuring everyone followed the steps exactly so we didn’t skip a beat or get out of sequence,” says Rodriguez, adding, “it went better than expected”. A team of more than 140 healthcare professionals raced against time so they could limit the amount of time the donated tissue went without receiving a blood supply, transplanting both hands up to the mid-forearm. DiMeo’s face, including the forehead, eyebrows, ears, nose, eyelids, lips and skull line, cheek, nasal and chin bone, were also transplanted. The operation, which took 23 hours, should allow DiMeo to perform normal functions including dressing and feeding himself. Using free weights, he has started strength and resistance training, playing with his dog, Buster, and has even started practicing his golf swing. “The rehabilitation demands on Joe are greater than any of our previous face transplant patients,” Rodriguez said. “He’s completely focused on his goal of gaining greater independence and freedom.” Two other simultaneous face and hand transplant have been attempted in the past, although with starkly different outcomes. One patient ultimately died from complications related to an infection. Another prior recipient had the hands removed after their body failed to accept them. “Joe was an ideal candidate for this procedure; he’s extremely motivated and dedicated to recovering the independence he lost after his accident,” Rodriguez told The Today Show. DiMeo has, so far, not experienced any rejection to the transplant.