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Complex Case Spotlight

The Rehabilitation Course for the World’s First Face & Double Hand Transplant

Joseph DiMeo in Hospital Bed

An Extraordinarily Complex Case

In July 2018, a car accident left 22-year-old Joseph DiMeo with third-degree burns covering 89 percent of his body and post-traumatic facial deformity from composite tissue loss of the face.

Additional diagnoses were severe neck contracture, bilateral partial facial paresis, respiratory failure, tracheostomy, and oral incompetence. Tissue loss had also caused vision loss and hearing impairment.

In July 2018, Joseph DiMeo was in a car accident that changed the course of his life.
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Computer Rendering of Face and Double Hand Transplant

A Pioneering Surgery

Mr. DiMeo underwent approximately 20 reconstructive surgeries, yet still suffered extensive physical deficits, such as amputated fingertips, lips, and eyelids, and severe facial scarring.

The full face and bilateral forearm transplantation took approximately 23 hours and involved a team of more than 140 healthcare professionals, led by Eduardo D. Rodriguez, MD, DDS.

The combined full face and double hand transplant procedure was performed by Eduardo D. Rodriguez, MD, DDS, chair of the Hansjörg Wyss Department of Plastic Surgery, and the Helen L. Kimmel Professor of Reconstructive Plastic Surgery, in August 2020.
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Joseph DiMeo with Dr. Eduardo Rodriguez

Extensive Hospital Stays

Post-surgery, Mr. DiMeo spent five weeks in intensive care before being able to see his face for the first time. Dr. Rodriguez continued to monitor his progress and the many nerve and tissue grafts.

Mr. DiMeo then remained inpatient at Rusk Rehabilitation under the direction of Jeffrey M. Cohen, MD.

Mr. DiMeo spent five weeks in intensive care before being able to see his reconstructed face for the first time.
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Joseph DiMeo Working with Weights

Intensive Rehabilitation Program

Rehabilitation demands extended far beyond face transplant to include new hand-based orthoses and exercises to improve hand and grip strength. The nursing team educated Mr. DiMeo on the importance of daily standing and walking, plus passive stretching to prevent contractures. Therapists also performed tissue massage to help remodel scar tissue on his forearms, hands, shoulders, and neck.

Joe DiMeo’s rehabilitation protocols were created by physical and occupational therapists at NYU Langone’s Rusk Rehabilitation.
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Before and After Rehabilitation Images

Hand Therapy and Fine Motor Dexterity

Prior to rehabilitation, Mr. DiMeo’s serial opposition, or his ability to touch digits 2 through 5 to the tip of his thumb, was significantly impaired. After extensive work on his fine motor dexterity, his grip strength markedly improved, allowing him to complete fine motor tasks independently, such as the ability to pick up a utensil.

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April D. O’Connell, OT/L, clinical specialist for hand and upper extremity rehabilitation, designed a unique hand therapy protocol with the goal of getting Mr. DiMeo back to the activities of everyday life.
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Podcast: Rusk Insights on Rehabilitation Medicine

Hear experts from NYU Langone’s Rusk Rehabilitation and other leaders from across the rehabilitation field discuss the latest in research, treatment options, and other timely topics on the Rusk Insights on Rehabilitation Medicine podcast.

Search “Rusk” on the Podcast app (Apple devices) or Stitcher (Android devices) to find the podcast and subscribe.

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