Life after a historic eye transplant

In new research published Monday in the Journal of the American Medical Association, doctors from NYU Langone share what they've learned since a team of surgeons performed the first eye and face transplant.

47 year old Aaron James of Arkansas hasn’t regained vision, but his recovery is progressing.

"I can feel pretty much my whole face. The only thing is, my lips are still a little, a little numb," James said. "I guess my brain is already, I guess, gotten used to this, this face. But you know when I see my old self. I don't know. It's just kind of it's get where. It's kind of weird looking to me now."

In May 2023, a team of more than 140 medical professionals spent more than 20 hours in two operating rooms to complete the transplant. James had survived a high voltage electrocution and lost his left eye, left eyelid, nose, lips, and skin and muscle tissue in his face. He also lost his arm and suffered kidney damage.

He says recovering has not been easy. He adds that he thinks about his donor, and their family.

“Without a donor this would not have been possible. That gives me a little something to kind of shoot for, you know. Make them proud that they made the right decision.”

RELATED STORY | Doctors perform kidney transplant on awake patient, who is out of hospital in 1 day

In the newly published research, researchers say the transplanted eye kept normal pressure and blood flow — which was a different outcome than what has been documented in animal studies, in which the eye would often shrink. Since James is the first human recipient of a transplanted eye, it’s unclear timeline wise when or if he’d regain vision entirely.

“If you shine a light in, there's an electrical signal generated by the nerves that are in the retina," Dr. Daniel J. Ceradini , plastic surgery research director at NYU Langone, told Scripps News.
"We're still studying whether that actually makes it back to the brain. There is preliminary data that suggests that it may, but it's very early to tell. Aaron has been without sight for now, two years. It's unclear whether his brain may have to relearn how to see or interpret visual signals the way we connected them or how that would work.”

James is back to his daily life, now with much more use of his mouth, for one thing. He spoke fondly about a recent family reunion and sending his daughter off to college. But even post-transplant, there’s risk to his health.

Previous face transplant cases have shown "the need for lifelong systemic immunosuppression, which itself carries serious risks of organ failure, sepsis, and even death in the context of a non-lifesaving transplant,” the study says.

James continues clinic visits every three months, and the data will be used in future research. It's a small step, but still a big hope for the future of potential whole-eye transplants which could one day restore sight.

“There are a lot of patients out there that don't have necessarily a large facial injury, but have a either a traumatic or a loss due to disease. And so figuring out the surgical approach to that will be something that we're actively studying,” Ceradini said.

RELATED STORY | First pig kidney recipient dies nearly 2 months after transplant