Details emerge about Poland's first face transplant

A 33-year-old Polish man received a face transplant just three weeks after being disfigured in a workplace accident, in what his doctors said Wednesday is the fastest time frame to date for such an operation. It was Poland's first face transplant.

Face transplants are extraordinarily complicated and relatively rare procedures that usually require extensive preparation, typically months or years. But medical officials said the Polish patient's condition was deteriorating so rapidly that a transplant was seen as the only option. The patient is now being watched for any potential infections.

The patient worked at stonemason's workshop near the southwestern city of Wroclaw where on April 23 a machine used to cut stone tore off most of his face and crushed his upper jaw.

The man, identified only as Grzegorz, received intensive treatment at a hospital in Wroclaw, but an attempt to reattach his own face failed, leaving an area close to the brain exposed to infections, doctors said. The damage was too extensive for doctors to temporarily seal the exposed areas.

So he was taken to the Cancer Center and Institute of Oncology in Gliwice, which is the only place in Poland licensed to perform face transplants. The center has experience in facial reconstruction for patients disfigured by cancer and its experts have practiced face transplants on cadavers.

Doctors at the center said the 27-hour face and bone transplant was performed May 15 soon after a matching donor was found.

The surgery reconstructed the area around the eyes, the nose, jaws and palate and other parts of the man's face. Pictures show surgery stitches running from above the patient's right eye, under the left eye and around the face to the neck.

The donor, a 34-year-old man, was chosen from a national registry of potential donors after his age, gender, blood group and body features were determined to be a good match for the injured man.

The head of the team of surgeons and other specialists, Dr. Adam Maciejewski, said the operation was the world's first life-saving face transplant carried out so soon after the damage. Face transplants are usually a last resort after conventional reconstructive and plastic surgeries have been tried.

"In such an extensive injury, where the structures close to the skull base and in contact with the brain area are exposed, any infection would be dangerous, not to mention the impossibility to function normally including problems with breathing, with eating," Maciejewski said. "All that led us in one direction."

"We assume the surgery will allow the patient to return to normal life. He will be able to breathe, to eat, to see."

The patient is now breathing on his own and responds to questions by nodding his head or squeezing the hands of doctors. But his condition is serious and it will be months before the doctors can describe the procedure as a full success, said Dr. Krzysztof Olejnik, head of the team of anesthesiologists.

Another member of the transplant team, surgeon Dr. Michal Grajek, told The Associated Press that the patient is receiving drugs to ward off any potential viral, bacterial or skin infections.

Though he is in sterile isolation, the patient has started the rehabilitation process. He will stay on special drugs for the rest of his life to prevent rejection of his new face.

A picture of the patient taken Tuesday, six days after the surgery, showed him giving a thumbs-up sign from his hospital bed. Another picture, based on computer tomography, shows the extensive damage to his skull.

More than two dozen transplants of the face or parts of the face have been performed around the world. The first one was a partial face transplant in a woman maimed by her dog in France in 2005. The United States performed their first facial transplant in March 2011. Dallas Wiens, a 25-year-old from Fort Worth, Texas, received a new face at Brigham and Women's Hospital at Boston, after his face was horribly burned by a high-voltage electrical line in 2008. He has been able to keep his new face and regained the ability to smile. He married a burn victim he met in a support group in March 2013.