But last month, Tarleton, a 52-year-old former nurse, chose to do it again, making her the first and only the second to ever have had the procedure twice.
According to the hospital statement, the surgery took place at Women’s Hospital and Brigham in Boston in July, with the participation of more than 45 clinicians in about 20 hours.
Tarleton, who is recovering at home in New Hampshire, told CNN: “That first face transplant served me very well. “And when it started to fail, I learned from my experience that facial implants gave me the comfort and function I wanted and needed on a daily basis – that I would have a better life. with face transplantation. “
Now, she says, “all the pain I went through in the face of my failure is gone.”; Since the surgery, she said that she only experienced pain related to “incision and swelling”.
Her doctors have agreed that recovery is going well.
“Carmen is progressing and recovering very well with this second transplant – she is one of the most resilient patients I have the chance to take care of,” said Dr. Bohdan Pomahac, Director of Surgical Surgery Implants. America Brigham, who led the effort, said in the release. “We call this procedure life giving and we are happy to give her the chance to return to the life she deserved.”
The hospital said the burn caused complications during the first surgery
She and the hospital say Tarleton’s first face transplant was unsuccessful because her body began rejecting donor tissue, causing scarring, stretching, swelling and pain, she and the hospital said.
Since she becomes sensitive to life-saving blood products and tissue transplants to treat her burns, Tarleton is more likely to reject the first transplant in terms of immunity, the hospital said.
“During the second face transplant, Carmen was not highly hypersensitive, had no high risk of rejection, as she had lost nearly all of the HLA antibodies in her blood that made her previously susceptible – possibly is due to the immunosuppression that she received in the first transplant, “Dr. Anil Chandraker, a member of the transplant team, said in a press release.
The hospital said this time Tarleton had an “abnormal matching tissue” from the donor.
Dr. Pomahac told CNN that the tissue is so close that it’s “more relevant than you’d see in your siblings.”
A new approach to a complex operation
According to Dr. Pomahac, the latest surgery could also be a new approach to face transplantation in the future.
The surgical team decided to halt the transplant for about 15 hours to control the amount of blood loss, which could make the clotting process more difficult, the hospital said.
Dr Pomahac said that the shutdown option, which was not planned, also allowed a new team to perform the most important and complex part of the operation – the inner part – when the blood vessels were attached. rejoining and the tissues around the nose, eyelids, and lips are in balance.
The team completed the insertion the next day.
“It’s difficult to be asked how difficult it is to get a second face transplant,” said Dr. Pomahac.
Although they have considered whether to perform conventional facial reconstruction, Dr. Pomahac said they decided to do it after Tarleton stressed that the first face transplant had improved the quality of life. How is she.
The pandemic also complicates the situation, he said.
All elective surgeries were halted, not to mention all transplant surgeries because the donor’s tissue was not routinely examined for Covid-19 at that time. There are also issues with out-of-state team members possibly coming from other viral hotspots, says Dr. Pomahac.
As far as possible
“One can expect the implants to last the patient’s life, but practically all implants have a finite lifespan,” said Dr. Pomahac in a statement in the press release. .
While Tarleton is recovering well, the long-term survival of the transplant remains to be considered, he said.
The next major milestone, he added, would normally take three to six months and continue to progress afterward.
“This face transplant is lighter, smaller and better suited to my head,” she continued. “My blindness keeps me from seeing the big details, but when I look in the mirror I can see that I have a different face. It looks paler than my first face.”
Tarleton said she remains good friends with the original donor’s family.
Due to the pandemic, she remains socially distant – so she has FaceTiming with loved ones, who are still getting to know the new Carmen.
“My sister said, ‘I’m just staring at you so my brain knows it’s you’,” Tarleton said. “I look more like me before I got burned.”
CNN’s Stephanie Becker contributed to this report.