The patient, 55 year old James Boysen, had been suffering from a rare type of cancer of the muscles in his scalp called leiomyosarcoma. Chemotherapy and radiotherapy resulted in him losing his scalp and then it went on to destroy most of his his skull, according to the BBC.
The Guardian quotes Dr Selber, the co-leader of the surgical team that performed the operation, who explained;
“He had series of cancers of the scalp and skull that were treated with various surgeries and radiation that left him with a large wound that was all the way down to his brain.”
But, Mr Boysen faced another problem. He had developed diabetes at 5 years of age says RT, which necessitated kidney and pancreas transplants. These organs were now failing and needed immediate treatment, but, at the same time, the destruction of his skull also needed urgent attention
Live Science says that his doctors were left with a quandary, because they couldn’t do two separate operations for fear of deadly consequences.
The hole in Boysen’s head meant he would be vulnerable to infection if they carried out his needed kidney and pancreas transplants.
Selber told Live Science,
“A preexisting wound, especially one of that magnitude, is a major risk for infection. There’s a general rule that if there’s a major wound, you don’t want to perform a transplant.”
On the other hand, closing the wound in his head with reconstructive surgery could also lead to irreversible pancreas and kidney failure.
But, Dr Selber, suddenly realized there was a rare opportunity to overcome the predicament by doing both procedures at the same time.
“When I first met Jim, I made the connection between him needing a new kidney and pancreas and the ongoing anti-rejection medication to support them, and receiving a full scalp and skull transplant at the same time that would be protected by those same medications.
“This was a truly unique clinical situation that created the opportunity to perform this complex transplant,” he said.
It meant carrying out a 10 by 10 inches (25 cm by 25 cm) skull transplant covering “the entire top half of the head.”
The procedure was no mean feat. Another surgeon involved in the remarkable operation, Dr Michael Klebuc, from Houston Methodist Hospital, said:
“This was a very complex surgery because we had to transplant the tissues utilizing microsurgery.
“Imagine connecting blood vessels 1/16 of an inch under a microscope with tiny stitches about half the diameter of a human hair being done with tools that one would use to make a fine Swiss watch.”
The extremely difficult operation took 15 hours and involved preparations by some 50 medical professionals.
Dr Selber said: “The coordination of care was really complicated. We had to coordinate multiple surgical teams from different hospitals doing things we’ve never done before.”
A spokesman for the Houston Methodist Hospital and the Anderson Cancer Center said in a statement that Mr Boysen “is the first patient to receive the simultaneous craniofacial tissue transplant together with solid organ transplants.”
Science Alert said that Boysen was in “awe” of what the doctors were able to do. Not only was it an incredible surgical success, but they were even able to match his natural skin and hair color.
He’s said that feeling has already returned to the top of his head, joking that. “It’s kind of shocking, really, how good they got it. I will have way more hair than when I was 21.”
He told Reuters that:
“I’m amazed at how great I feel and am forever grateful that I have another chance to get back to doing the things I love and be with the people I love.”
