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Surgeons in New York believe they may be one step closer to curing blindness after an Arkansas man became the first known patient to successfully receive a complete eye transplant in May.
NYU Langone Health announced the accomplishment on Thursday. Representatives for the academic medical centre said 46-year-old military veteran Aaron James received a donated eye — and donated optic nerve — and underwent a rare partial face transplant.
James, a former lineman, was injured in June 2021 after surviving a workplace accident involving high-voltage power lines. The 7,200-volt electric shock caused James to lose his left eye and much of his face.
James’ right eye is still functioning.
Less than two years after his injury, James became the first person in known medical history to ever successfully undergo a whole-eye transplant, though he does not have sight through the donated eye.
It is unclear if he will ever regain his sight in the new eye, though James told The Associated Press he has regained some sensation in the region since the surgery.
“The transplanted left eye has shown remarkable signs of health, including direct blood flow to the retina — the area at the back of the eye that receives light and sends images to the brain,” Langone Health wrote in a statement.
The surgery took 21 hours and replaced half of James’ face.
More than 140 healthcare professionals were involved in the procedure.
The surgery lasted approximately 21 hours and included a team of more than 140 surgeons, nurses, and other healthcare professionals, led by Dr. Eduardo D. Rodriguez.
Joe Carrota/ NYU Langone Staff
“This achievement demonstrates our capacity to embrace the most difficult challenges and drive continuous advancements in the field of transplantation and beyond,” said Dr. Eduardo D. Rodriguez, who led the surgery.
“The mere fact that we’ve accomplished the first successful whole-eye transplant with a face is a tremendous feat many have long thought was not possible,” he continued. “We’ve made one major step forward and have paved the way for the next chapter to restore vision.”
Following James’ workplace accident, he was forced to lose his left eye after it began causing him severe pain. James also lost his dominant left arm from above the elbow, his entire nose and lips, front upper teeth, and left cheek area as well as his chin down to the bone.
With James’ eye specifically, Rodriguez and his team of surgeons cut the patient’s optic nerve as close to the eyeball as possible in the hopes of potential transplant.
Though corneal transplants are fairly common, whole-eye transplants are very complex and pose a number of challenges surrounding regeneration, immune rejection and retinal blood flow.
James and his medical team eventually decided to move forward with a whole-eye transplant in combination with the face transplant, though the risky surgeries were likely to only provide cosmetic benefits. To restore a patient’s vision, surgeons would have to reconnect the optic nerve to a patient’s brain. James’ doctors felt, whether functional or not, the donated eye would better support the facial transplant and provide cosmetic benefits around patient’s eye socket and lid.
This combination of photos provided by NYU Langone Health in November 2023 shows Aaron James before and after his high-voltage electricity accident and after a facial and eye transplant.
NYU Langone Health via AP
Within three months, a potential donor was identified.
The donor, a man in his 30s, reportedly “came from a family that strongly supports organ donation.” His donated tissues were used in James’ surgeries, but also saved three other lives using the donor’s kidneys, liver and pancreas, according to Langone Health.
In the hopes of improving the likelihood of nerve regeneration in the donated eye, James’ surgical team injected the donated hazel eye with adult stem cells derived from the donor’s bone marrow. Doctors now hope the cells will divide and create more healthy cells that can replace damaged or dysfunctional nerves.
This was also the first known instance of injecting adult stem cells into a human optic nerve during a transplant.
For James’ facial transplant, medical professionals used state-of-the-art technology and three-dimensional computer surgical planning to optimize their approach. After meticulous planning, surgeons were able to fit the eye and grafted partial face onto James.
As of now, James can’t yet open the new eyelid and wears an eyepatch to protect it.
This family photo shows Aaron James and his daughter, Allie in September 2022.
NYU Langone Health via AP
Throughout his surgical procedures, James also underwent an intensive immunosuppression regimen to prevent rejection of the donated cells.
He spent 17 days in the intensive care unit (ICU) before he was discharged on July 6. From home, James continued physical, occupational and speech therapy.
“I’m grateful beyond words for the donor and his family, who have given me a second chance at life during their own time of great difficulty. I hope the family finds solace in knowing that part of the donor lives on with me,” James said. “I will also forever be thankful to Dr. Rodriguez and his team for changing my life. My family and I wouldn’t have been able to navigate this difficult journey without their expertise and support. Our hope is that my story can serve as inspiration for those facing severe facial and ocular injuries.”
In the coming months, James plans to undergo orthodontic treatment and dental rehabilitation. But for now, James said he is looking forward to Thanksgiving in the U.S. — the first holiday meal he said he will be able to eat since his injury.
Surgeons and academics are calling James’ case a leap forward in the quest to cure blindness. Though science is still a long way away from fully restoring sight to patients, medical professionals are hoping James’ “groundbreaking” whole eye transplant will open the door for a myriad of other scientific breakthroughs.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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