Woman mauled by chimp gets new face

June 11, 2011|By Liz Kowalczyk, Globe Staff

Steve Nash, brother of face transplant recipient Charla Nash, listened… (Jonathan Wiggs/Globe Staff )

A Connecticut woman who was attacked by a chimpanzee received an entirely new face at Brigham and Women’s Hospital last month, but a simultaneous double hand transplant failed when she experienced an unusual cascade of complications after surgery.

Doctors at the Brigham, who performed three previous face transplants, publicly discussed Charla Nash’s operation for the first time yesterday, describing it as the most difficult face transplant they have done because of the extreme nature of Nash’s injuries. The surgery took place in late May, on an undisclosed date to protect the donor’s identity.

Nash, 57, was unable to see her new face because the February 2009 attack left her blind. But an older brother, Steve, described it during a news conference as “beautiful’’ and “amazing.’’ Surgeons called the face transplant a success, saying that over the next few months, Nash should gradually be able to eat, breath, talk, and smile normally.

The failure of the hand transplants after Nash suffered a potentially life-threatening infection was the first down note for the Brigham team, which has enjoyed tremendous success over the past two years and grown into world leaders in face transplantation. Nash, who is in the intensive care unit, will experience a slower recovery than the previous face transplant patients because of the complications.

The Cleveland Clinic, which performed the first partial face transplant in the United States, and where Nash went for reconstructive surgery after the attack, had turned her down for face and hand transplants, saying her injuries were “too complex.’’

But the Brigham surgeons, though they had never performed a hand transplant, decided to perform the pro cedures simultaneously in part because Nash was eager for new hands. The chimp tore off her left hand and lower arm and her right hand except for the thumb.

Lead surgeon Dr. Bohdan Pomahac described Nash as a “courageous and strong person who inspired the team to do everything possible.’’ He said that after a rigorous screening process, the team felt strongly they could perform the surgery successfully. So orthopedic and hand surgeons were added to the face transplant team. The donor’s family, who want to remain anonymous, agreed to provide the face and hands.

The 20-hour operation was challenging, Pomahac said during an interview, because the donor’s hands had relatively few blood vessels to connect to Nash’s vessels. Still, the surgery worked, and Nash’s heart pumped blood into her new hands.

About a day later, however, she developed pneumonia, which progressed into sepsis, a bloodstream infection, and her blood pressure dropped. Because of this, the new hands did not receive enough blood and doctors removed them several days later.