A New Jersey man has had the world's first successful face and double hand transplant from the same donor, two years after a car accident left him with burns over 80 percent of his body.
Joe DiMeo, 22, received the transplant in August at NYU Langone Health Center. He has been recovering ever since. DiMeo fell asleep at the wheel of his car after working a night shift in 2018. The vehicle then exploded and he was pulled from the wreckage.
In August, doctors found a match for him - an unidentified donor in Delaware. He had just a six percent chance of a match because of all of the surgeries he'd already undergone.
The surgery took 23 hour, 16 doctors and was carried out between two operating rooms but it was a success - his body accepted the new organs.
Now, DiMeo is speaking out for the first time to thank his donor's family.
Appearing on Good Morning America on Wednesday, he said: 'When I saw my face for the first time, it didn't hit me. It didn't seem real at first.
'The swelling comes down every day. I see my cheek bones now.'
He also said he wanted to one day meet his donor's family.
'I'm grateful for them to give this gift to me - I don't know how to thank someone that gives you a second chance at life,' he said.
Joe DiMeo, 22, received new hands and a face from an unidentified donor in Delaware in August. He is the first in the world to survive the surgery and accept both the hands and the face
Joe is pictured before the car wreck in 2018 that left his body 80% covered with burns
After his accident, DiMeo spent months in a medically induced coma
He underwent 20 reconstructive surgeries and multiple skin grafts to treat his extensive third-degree burns
His father John added: 'From the moment after the operation, when we walked through that door... that's him now.'
DiMeo is the first in the world to successfully receive a new face and both hands from the same donor - an unidentified man in Delaware.
Isabelle Dinoire became the world's first face plant recipient in France in 2005. She died 11 years later from cancer.
It has been attempted twice before; first in Paris in 2009 but the patient died from complications a month later. In Boston in 2011, a woman who was mauled by a chimpanzee received hands and a face from the same donor but her body rejected the hands and they were removed.
'I knew it would be baby steps all the way,' DiMeo told The Associated Press. 'You've got to have a lot of motivation, a lot of patience. And you've got to stay strong through everything.'
Experts say it appears the surgery, which took place in August at NYU Langone Health, was a success, but warn that it will take some time to say for sure.
Worldwide, surgeons have completed at least 18 face transplants and 35 hand transplants, according to the United Network for Organ Sharing, or UNOS, which oversees the US transplant system.
But simultaneous face and double hand transplants are extremely rare and have only been tried twice before. The first attempt was in 2009 on a patient in Paris who died about a month later from complications.
Two years after that, Boston doctors tried it again on a woman who was mauled by a chimpanzee, but ultimately had to remove the transplanted hands days later.
'The fact they could pull it off is phenomenal,' said Dr Bohdan Pomahac, a surgeon at Boston's Brigham and Women's Hospital who led the second such attempt. 'I know firsthand it's incredibly complicated. It's a tremendous success.'
DiMeo will be on lifelong medications to avoid rejecting the transplants, as well as continued rehabilitation to gain sensation and function in his new face and hands.
A 2018 car accident left DiMeo with severe burns over 80 percent of his body. He said he fell asleep at the wheel after working a night shift as a product tester for a drug company.
His car hit a curb, then a utility pole, flipped over and burst into flames. Luckily, another driver who saw the accident pulled over and rescued DiMeo.
Afterwards, DiMeo spent months in a medically induced coma and underwent 20 reconstructive surgeries and multiple skin grafts to treat his extensive third-degree burns.
His fingers had to be amputated, he had no lips and his eyelids had completely fused, People reported.
Once it became clear that conventional surgeries would not help him regain full vision or use of his hands, DiMeo's medical team began preparing for the risky transplant in early 2019.
DiMeo (right) will be on lifelong medications to avoid rejecting the transplants, as well as continued rehabilitation to gain sensation and function in his new face and hands. Pictured: DiMeo and Dr Eduardo Rodriguez (left) demonstrate the flexibility and strength of DiMeo's new hands
Worldwide, surgeons have completed at least 18 face transplants and 35 hand transplants, according to the United Network for Organ Sharing, or UNOS, which oversees the US transplant system. But simultaneous face and double hand transplants are extremely rare and have only been tried twice before and both patients subsequently died. Pictured: Rodriguez (left) and DiMeo demonstrate gripping with DiMeo's new hands
Doctors estimated DiMeo only had a six percent chance of finding a match compatible with his immune system. They also wanted to find someone with the same gender, skin tone and hand dominance. Pictured: Rodriguez (left) and DiMeo (right) demonstrate the flexibility of DiMeo's new hands
In early August, the team finally identified a donor for DiMeo (pictured six months after his transplant) in Delaware and completed the 23-hour procedure two days later
During a recent session, he practiced raising his eyebrows, opening and closing his eyes, puckering his mouth, giving a thumbs up and whistling. DiMeo can feel his new forehead and hands get cold, and often reaches up to push his long hair off of his face
Since leaving the hospital in November, he has been in intensive rehabilitation, devoting hours daily to physical, occupational and speech therapy. Pictured: DiMeo uses a knife and fork to cut some modelling plastic during an occupational therapy session
'Within the world of transplantation, they're probably the most unusual,' said Dr David Klassen, UNOS chief medical officer.
Almost immediately, the NYU team encountered challenges including finding a suitable donor.
Doctors estimated DiMeo only had a six percent chance of finding a match compatible with his immune system. They also wanted to find someone with the same gender, skin tone and hand dominance.
'We knew that it would be a needle in a haystack,' Dr Eduardo Rodriguez, who led the medical team of more than 140 people, told Good Morning America, adding that all DiMeo's previous surgeries added to the complication.
'We had to actually broaden our search beyond the state of New York, to the entire country, so every state in the country was actually looking for a donor for Joe.'
The pandemic complicated the search for a donor, with organ donations plummeting and members of the transplant unit reassigned to work in COVID-19 wards during New York City's surge.
In early August, the team finally identified a donor in Delaware and completed the 23-hour procedure two days later.
DiMeo (left), who has lived with his parents since the accident, can now dress and feed himself. He shoots pool and plays with his dog Buster
Once an avid gym-goer, DiMeo (right) is also working out again — benching 50 pounds and practicing his golf swing
DiMeo told People that he was 'way ahead' of schedule with his rehabilitation. 'Right now I have 20 lbs. of grip, and most people don't have that in five months, that usually takes a year. And I'm getting a lot of sensation and grip back.
They amputated both of DiMeo's hands, replacing them mid-forearm and connecting nerves, blood vessels and 21 tendons with hair-thin sutures.
They also transplanted a full face, including the forehead, eyebrows, nose, eyelids, lips, both ears and underlying facial bones.
'The possibility of us being successful based on the track record looked slim,' Rodriguez said.
'It's not that someone has done this many times before and we have a kind of a schedule, a recipe to follow.'
'When we completed this operation and I looked at Joe with a new face and two arms and they look perfect, I was so proud of this team that came together, and even more so through this great health crisis that none of us have ever experienced, and we pulled it off,' Rodriguez told People.
Good Morning America reported that DiMeo spent 45 days in hospital following the operation then went to a rehabilitation center before being discharged in November.
So far, he has not shown any signs of rejecting his new face or hands, Rodriguez said.
Since leaving the hospital in November, he has been in intensive rehabilitation, devoting hours daily to physical, occupational and speech therapy.
'Rehab was pretty intense,' DiMeo said, and involves a lot of 'retraining yourself to do stuff on your own again.'
During a recent session, he practiced raising his eyebrows, opening and closing his eyes, puckering his mouth, giving a thumbs up and whistling.
DiMeo can feel his new forehead and hands get cold, and often reaches up to push his long hair off of his face.
DiMeo, who has lived with his parents Rose and John since the accident, can now dress and feed himself. He also shoots pool and plays with his dog Buster.
He told People that he was 'way ahead' of schedule with his rehabilitation.
'Right now I have 20 lbs. of grip, and most people don't have that in five months, that usually takes a year. And I'm getting a lot of sensation and grip back.
'I can feel the fur of my dog, or when he licks his palm, and it makes me happy. It's the small things you do every day, and you don't know it's gone until you lost it.'
DiMeo said he can now feel his dog's fur as well as when it licks his hand. Pictured: DiMeo with his dog Buster
DiMeo (center) with his parents Rose (left) and John (right) in the backyard of their New Jersey home six months after DiMeo's transplant
Dr Eduardo Rodriguez (left) told People that DiMeo's own tenacity has been crucial to his recovery. 'This is an individual with tremendous amount of courage, who went into an operation not knowing if he's going to come out of alive
Once an avid gym-goer, DiMeo is also working out again — benching 50 pounds and practicing his golf swing.
'You got a new chance at life. You really can't give up,' he said.
As with any transplant, the danger of rejection is highest early on, but remains indefinitely. The medications he takes also leave him vulnerable, for the rest of his life, to infections.
'You're never free from that risk,' Klassen said. 'Transplantation for any patient is a process that plays out over a long period of time.'
Still, Rodriguez said he's amazed to see that DiMeo has been able to master skills like zipping up his jacket and putting on his shoes.
'It's very gratifying to all of us,' Rodriguez said. 'There's a tremendous sense of pride.'
Rodriguez told People that DiMeo's own tenacity has been crucial to his recovery.
'This is an individual with tremendous amount of courage, who went into an operation not knowing if he's going to come out of alive.
'He just has that mentality and hope and a mental strength that he will succeed. And that is a major element that has helped him heal and help him get back to normal.'
DiMeo is thankful to the anonymous donor who provided his new face and hands and has written to the man's family.
'I sent them a letter, but I know they just had someone passed away, so I'm not trying to rush them or anything,' he told Good Morning America.
'I'm very grateful for them to give this gift to me, and I don't really know how to thank someone that, you know, gives you a second chance at life. I'm very thankful for it.'
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