Injured Firefighter Undergoes the World's Most Extensive Face Transplant

Patrick Hardison was a volunteer firefighter in small-town Mississippi when the accident happened. A house was in flames, with a person trapped, and the roof collapsed just after Hardison raced inside. His helmet was knocked off; he felt his mask melting. He closed his eyes and jumped out the window.

The young man lost his eyelids, ears, lips, most of his nose and his hair that day. He also had disfiguring third-degree burns across his entire face, head, neck and upper torso. His skin was so badly damaged that he was not even able to close his eyes completely.

"From that day on, Sept. 5, 2001, there was no normal tissue left throughout his face," Eduardo D. Rodriguez, chair of plastic surgery at New York University's Langone Medical Center, said in recounting the first responder's story.

In a press conference on Monday, the medical center announced that Hardison, now 41 and a father of five, had undergone the world's most extensive face transplant to date. The donor was a young BMX cyclist from Ohio named David Rodebaugh, whose family donated his liver, kidneys, and both eyes to help other patients. A representative from LiveOnNY, which works to match donors with recipients in the New York metropolitan area, said his mother didn't hesitate when asked about the face transplant and called her son "a free spirit who loved life."

Rodebaugh died in July when he crashed and hit his head while riding in Brooklyn. He was 26 - virtually the same age as Hardison was when he was injured.

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The years following the fire were full of dark, horrific pain. Hardison underwent more than 70 surgeries that involved multiple grafts from his leg to his face. Yet he was still very disfigured - with "no semblance of normal anatomy," as Rodriguez put it - and had to hide behind sunglasses and a baseball cap whenever he went out. Talking or eating was excruciating.

A friend at Hardison's church heard about the work Rodriguez had done at the University of Maryland Medical Center for another man whose face had been damaged and contacted the surgeon on his behalf. Hardison became a patient of Rodriguez's while the doctor was at UMMC and continued to work with him after he was recruited to join NYU Langone.

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The transplant operation, which took place Aug. 14, was funded by a grant from NYU Langone. The hospital estimates it cost between $850,000 and $1 million.

The university said that just three months after the surgery - a critical period when most rejections occur - Hardison is "doing well and is quickly returning to his daily routines."

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"I am deeply grateful to my donor and his family," Hardison said in a statement. "I hope they see in me the goodness of their decision."

Rodriguez said that one of the most moving moments for him was when Hardison went out after his surgery to buy clothes. "For him it was so remarkable that no one stared at him. . . . It was a very emotional exchange for us," Rodriguez said.

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The medical science behind transplants has been progressing at a rapid pace in recent years. Patients have seen miraculous results with womb transplants, penis transplants and hand transplants as well as tongue transplants.

The world's first partial face transplant was performed in 2005 in France on a woman who lost her lips, cheeks, chin and most of her nose after she was mauled by her dog. The first full face transplant took place in 2010 in Spain. The procedures set off a firestorm of ethical debate about whether such risky surgeries should be undertaken to improve someone's quality of life - rather than save it.

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In 2012, the University of Maryland Medical Center announced that it had completed what was then the most comprehensive face transplant on a 37-year-old man who had been disfigured after a gun accident 15 years earlier. The 36-hour operation involved more than 150 doctors, nurses and staff members.

In total, roughly 35 patients worldwide have had face transplants. The chance of complications, even death, are very high. Even if the initial surgery, which is enormously complicated and dangerous, goes well, they face significant risk that their body will reject the foreign part. Many doctors believe these patients will have to take immunosuppressant drugs their whole lives.

The U.S. military is funding a study that is attempting to wean face transplant patient Charla Nash off such medications, which can make the patients more vulnerable to other illnesses.

Doctors hope that Nash, who was left without lips, eyes or eyelids after being attacked by an employer's pet chimpanzee in 2009 and received a face transplant in 2011, will be able to replace the immunosuppressant drugs with Interleukin-2. The latter can have less serious side effects and is usually used to treat cancers.

© 2015 The Washington Post