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Doctors in the US have completed the first ever skull and scalp transplant on a 55-year-old man. He has become the first person to receive the simultaneous craniofacial tissue transplant together with solid organ transplants.
The operation, which took a total of 15 hours to finish, involved a number of different techniques than a standard procedure.
After battling a rare type of cancer, the patient - James Boysen - was left without the whole of the crown of his head. He was diagnosed with leiomyosarcoma in 2006, and the treatment he received to attack the cancer on the muscle of the scalp left him with substantial permanent damage of the surrounding area.
As his scalp and skull were destroyed by the combination of chemotherapy and radiotherapy, his brain was vulnerable. Under normal circumstances, doctors would use skin grafts and metal plates to rebuild a skull.
However, in Mr Boysen's case, this was not viable. He was already on immune suppressing drugs because of the earlier kidney and pancreas transplants he had received, which were also in failure.
His struggling organs and medication he was on, prevented doctors from doing a reconstruction, while the ten by ten inch hole in the skull made an organ transplant impossible.
Conducted at the Houston Methodist Hospital and the Anderson Cancer Center, the procedure also involved giving Mr Boysen a new kidney and pancreas.
Dr Jesse Selber, who led the team at Anderson, said the hole covered "the entire top half of the head", according to the BBC.
He said: "When I first met Jim, I made the connection between him needing a new kidney and pancreas and the ongoing anti-rejection medication to support them, and receiving a full scalp and skull transplant at the same time that would be protected by those same medications."
Four years ago the surgeons first had the idea to combine the operations, but had to wait for a donor to become available.
Mr Boysen, a software developer, said he was "amazed" at how he feels after the surgery and said it had been a "long journey".
Dr Michael Klebuc, from Houston Methodist Hospital, said: "This was a very complex surgery because we had to transplant the tissues utilising microsurgery.
"Imagine connecting blood vessels 1/16 of an inch under a microscope with tiny stitches about half the diameter of a human hair being done with tools that one would use to make a fine Swiss watch."
The role of donors being so important in this instance, but there have been fresh concerns about the number of people signing up to the register to donate their blood and/or organs.
This has sparked a new campaign to encourage people in England and Wales to help save lives and enable life-changing operations to happen. There has been a 40 per cent drop in new volunteers in the past decade, with 120,000 fewer people joining the blood donor register in 2014-15 than in 2004-05.
It is calling for 204,000 new volunteers to start donating.
Written by Mathew Horton
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