When Aaron James, 47, accidentally touched a live electrical wire while working as a lineman, doctors didn’t know if he would survive.
The Arkansas Army veteran lost much of the left half of his face, his arm and his eye and could no longer smell, taste or move his mouth.
But last year, in a world-first operation that took 21 hours and involved 140 doctors at NYU Langone, Mr. James received a new eyeball and a new face from an anonymous donor.
The operation allowed his wife to kiss Meagan James, 39, again, to whom he has been married for more than 20 years. Ms James said her first kiss after the transplant was emotional and “just having him back was very special”.
Mr James (pictured with his wife, Meagan) spent just 17 days in intensive care. The two were able to kiss for the first time after the transplant.
Before his accident, Mr. James worked as an electrician and served several tours in the Middle East with the U.S. Army. Mr. James was discharged from the hospital in July, just months after his transplant surgery in May.
Since the surgery in New York in May 2023, doctors have closely monitored the Arkansas Army veteran for signs that the experimental surgery went wrong.
He has exceeded all predictions, recovering in ICU in record time and “far exceeding” the initial expectations of his transplant team.
Now he is enjoying doing “normal things” again, like eating solid foods.
Due to the severity of his injuries, the father of one of them had to follow a strictly liquid diet for two years.
“I knew I would be back to normal if I could eat pizza,” James said. And now, thanks to the experimental surgery, he can.
Dr. Eduardo D. Rodriguezsenior surgeon and director of the Face Transplant Program at NYU Langone, said: ‘Many experts did not believe we would get this far, but we have successfully transplanted and maintained an eye without immune rejection.
Dr. Rodriguez led the team of more than 100 surgeons, nurses and support staff as they harvested muscle, nerves, fat and skin, as well as the left eye, from an anonymous organ donor.
They then began a race against time, trying to attach every millimetre-wide nerve that controls the eye to Mr James’s face before the organ died. They also cleaned the area around the eye nerves with stem cells from the donor, hoping it would help the nerves grow back.
Dr. Elizabeth A. Bradley A Mayo Clinic ophthalmologist who was not involved in the transplant said: “The procedure was a huge undertaking both technically and technologically.”
Doctors have been theorizing about different ways to perform eye transplants since the 1970s, Dr. Bradley said, in part because there is no treatment for many forms of blindness, which affect more than a million Americans.
But it seemed nearly impossible to transport because almost as soon as it is removed from the donor, the eye’s nerves begin to die as they are deprived of blood flow, Dr. Bradley said.
Once an eye is implanted, the body can reject the new organ and react as if it were a virus or infection, making the recipient sick.
Mr. James, who had worked in public service both in the military and as a power lineman, was willing to take the risks.
“That’s really my biggest hope with this deal. I mean, if I can see through it, that’s great. But if it’s going to start the next path in the medical field, then I’m all for it.” Mr. James told CNN.
In the year since then, the body has maintained its size and blood flow, and the rest of the facial transplant also remained healthy.
At the moment, Mr James cannot see out of the donor eye, although his right eye still works well. However, blood flow and some further tests have doctors hopeful that there is still a chance he could see in the future.
Mr. James returned to Arkansas in September 2023 to his home with his wife and daughter (pictured).
For example, brain scans show activity in the part of the brain responsible for left eye vision, said Dr. Jeffery Goldberg, a Stanford ophthalmologist who was not involved in the research.
He added: “The MRI data are not conclusive enough to suggest regenerative growth, but they are a tantalizing piece of data that points towards that hope.”
Going forward, as long as the patient continues to take a complex cocktail of medications to keep the infection at bay, doctors will visit him periodically to monitor the progress of his eye.
“The next challenge is to understand how to restore vision. I look forward to continuing this research in collaboration with academia to accelerate these discoveries with unique tools and the best therapies,” said Dr. Rodriguez.
The fact that he cannot see with his eye at the moment has not diminished Mr James’ gratitude. He said he felt “honoured to be patient zero”.
“I have been given the gift of a second chance and I don’t take a single moment for granted.”