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Notable Moments in Limb and Face Transplant History

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In 2008, surgeons completed two procedures that could forever change transplant surgery. In August, doctors in Munich announced that a farmer was recovering from a double-arm transplant—the first double-arm transplant in the world. In December, the Cleveland Clinic announced they'd replaced about 80 percent of a woman's face. Many surgeons think that arm, hand, and face replacements are the next logical steps in transplants. Is the world ready?

Being first isn't always best

In 1964, physicians around the world were attempting transplants of all kinds when doctors in Ecuador performed the first hand transplant. Unfortunately, like early organ transplants, it didn't work—within two weeks the hand was rejected and doctors had to remove it.

Being second isn't much better

In 1998, doctors performed delicate microsurgery on New Zealander Clint Hallam. For 13 hours at Edouard Herriot Hospital, an international team of scientists led by French surgeon Jean Michel Dubernard stitched a cadaver's forearm and hand to Hallam's upper arm. Completing the hand transplant required microsurgery skills and patience—doctors knitted medial nerve to medial nerve, radial artery to radial artery, radius to radius. Like with other transplants, both donor and recipient must share the same blood type.

After years of studying transplant pioneers and earning a PhD based in xenographs research (he transplanted organs from one species of monkeys to another), Dubernard felt he was prepared to perform a hand transplant on a human. When he was unable to find a suitable French candidate, an Australian colleague recommended Hallam. Fourteen years earlier, Hallam had lost his forearm in a circular saw accident. It was later revealed the accident actually occurred in jail and that Hallam was a longtime con-man.

hands.jpgCritics claimed that Dubernard performed the surgery for the media attention, but the surgeon argued he and his staff did a thorough psychological evaluation of Hallam as well as a background check. (Unsurprisingly, Dubernard had a role in the first partial face transplant, also surrounded by controversy.)


At first, the forearm and hand worked well for Hallam, although he hated that the donor limb was larger than his other arm and a different skin tone. He hid his freak arm as much as he could. Hallam's arm wasn't just grotesque-looking, though; it began itching and flaking, and he was plagued daily by pins and needles. He begged the doctors to remove it, but they refused. Hallam felt emotionally detached from his hand. Finally, a group of British surgeons agreed to remove the limb in 2001. The physicians from France claimed the only reason Hallam's arm rejected is because he failed to take his immunosuppressant drugs and exercise it.

From hands to a face

Frenchwoman Isabella Dinore received the first partial face transplant in 2005.

After taking too many sleeping pills, Dinore had passed out. As she lay unconscious on the floor, her black Lab chewed off her nose, mouth, and lower face. Without lips, muscles, and skin on the bottom half of her jaw, Dinore struggled to speak and eat—she had to eat through a tube. Physicians couldn't help her with traditional plastic surgery and thus felt she would be a good candidate for a face transplant.

Bernard Devauchelle, a French maxillofacial surgeon at Lyon University, saw a picture of a brain-dead woman with a mouth, nose, and lips similar to Dinore's features. He removed a triangle of Maryline St. Aubert's skin with its arteries, nerves, and veins and spent hours graphing the skin onto Dinore's face.

Dinore.jpgIt was rumored St. Aubert was brain-dead because she tried to kill herself. Many people thought Dinore had attempted suicide, too. Dubernard, who had worked alongside Devauchelle in the surgery, argued Dinore accidentally overdosed. Physicians criticized the decision to give a suicidal woman a face transplant. People once again alleged Dubernard had performed the surgery for media attention—Corbis had an exclusive deal for photos—and some urged an ethics investigation.

Dubernard oversaw Dinore's recovery. Shortly after the surgery, he injected some of St. Aubert's stem cells (from her bone marrow) into Dinore in the hopes her body wouldn't reject the transplant, but the stem cell infusion failed. Dinore suffered two bouts of rejection, contracted herpes and a pox virus, and struggled with kidney failure.

A year later, Dinore appeared in the media, showing off her new face. She used her new lips to smoke again.

Full-face transplant

Coler.jpgLaurent Lantieri, head of plastic surgery at Henri-Mondor Hospital in France, spent 16 hours stitching new lips, cheeks, nose, and mouth to Pascal Coler's face. Since Coler was six years old, large masses had been growing on his nerves because of a condition called neurofibromatosis. As the masses increased in size, Coler's face became less recognizable. Strangers pointed at him because of his misshapen visage.


The large masses compressed the nerves, arteries, and fat in Coler's face, causing lasting damage; the transplanted cadaver's face stops the masses from developing. Lantieri didn't alter Coler's bone structure, so Coler looks as he would if he never had the disease.

What the doctors say

When a patient receives a lung or a liver, the body's white blood cells attack the new organ because the body believes it is an invader. That's why immunosuppressant drugs are so important for transplant patients: immunosuppressants mollify the immune system. When a transplant includes so many different tissues, organs, veins, arteries, nerves, fat, and bones, the body targets the limb even more ferociously than it attacks one organ—the white blood cells believe the more transplanted tissue means there are more invaders.

In 2007, a study was published with the results of 18 transplants of 24 hands/digits/forearms. (11 folks received one hand, four received two hands, two received two forearms, and one received one thumb.) The good news: limb transplantation has a 100 percent survival rate. (In the early days of organ transplantation, most patients died.) And graph survival is also 100 percent for the first two years. The bad news: 12 patients suffered acute rejection and six Chinese recipients had their hands removed. All patients had enough nerve function in their new limbs that they knew when they were hurt, but few used fine motor skills or had sophisticated nerve function.

Some experts wonder if limb transplants should be conducted when prosthetic limbs are available. Fifteen people in the 2007 study said the limbs improved their quality of life, but many suffer with lingering problems from the immunosuppressant drugs, kidney failure, diabetes, and infections.

One thing is certain, though: Dubernard won't be performing any more limb transplants. He reached the maximum age to practice medicine in France.

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4 Expert Tips on How to Get the Most Out of August's Total Solar Eclipse
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Richard Bouhet // Getty

As you might have heard, there’s a total solar eclipse crossing the U.S. on August 21. It’s the first total solar eclipse in the country since 1979, and the first coast-to-coast event since June 8, 1918, when eclipse coverage pushed World War I off the front page of national newspapers. Americans are just as excited today: Thousands are hitting the road to stake out prime spots for watching the last cross-country total solar eclipse until 2045. We’ve asked experts for tips on getting the most out of this celestial spectacle.

1. DON’T FRY YOUR EYES—OR BREAK THE BANK

To see the partial phases of the eclipse, you will need eclipse glasses because—surprise!—staring directly at the sun for even a minute or two will permanently damage your retinas. Make sure the glasses you buy meet the ISO 12312-2 safety standards. As eclipse frenzy nears its peak, shady retailers are selling knock-off glasses that will not adequately protect your eyes. The American Astronomical Society keeps a list of reputable vendors, but as a rule, if you can see anything other than the sun through your glasses, they might be bogus. There’s no need to splurge, however: You can order safe paper specs in bulk for as little as 90 cents each. In a pinch, you and your friends can take turns watching the partial phases through a shared pair of glasses. As eclipse chaser and author Kate Russo points out, “you only need to view occasionally—no need to sit and stare with them on the whole time.”

2. DON’T DIY YOUR EYE PROTECTION

There are plenty of urban legends about “alternative” ways to protect your eyes while watching a solar eclipse: smoked glass, CDs, several pairs of sunglasses stacked on top of each other. None works. If you’re feeling crafty, or don’t have a pair of safe eclipse glasses, you can use a pinhole projector to indirectly watch the eclipse. NASA produced a how-to video to walk you through it.

3. GET TO THE PATH OF TOTALITY

Bryan Brewer, who published a guidebook for solar eclipses, tells Mental Floss the difference between seeing a partial solar eclipse and a total solar eclipse is “like the difference between standing right outside the arena and being inside watching the game.”

During totality, observers can take off their glasses and look up at the blocked-out sun—and around at their eerily twilit surroundings. Kate Russo’s advice: Don’t just stare at the sun. “You need to make sure you look above you, and around you as well so you can notice the changes that are happening,” she says. For a brief moment, stars will appear next to the sun and animals will begin their nighttime routines. Once you’ve taken in the scenery, you can use a telescope or a pair of binoculars to get a close look at the tendrils of flame that make up the sun’s corona.

Only a 70-mile-wide band of the country stretching from Oregon to South Carolina will experience the total eclipse. Rooms in the path of totality are reportedly going for as much as $1000 a night, and news outlets across the country have raised the specter of traffic armageddon. But if you can find a ride and a room, you'll be in good shape for witnessing the spectacle.

4. PRESERVE YOUR NIGHT VISION

Your eyes need half an hour to fully adjust to darkness, but the total eclipse will last less than three minutes. If you’ve just been staring at the sun through the partial phases of the eclipse, your view of the corona during totality will be obscured by lousy night vision and annoying green afterimages. Eclipse chaser James McClean—who has trekked from Svalbard to Java to watch the moon blot out the sun—made this rookie mistake during one of his early eclipse sightings in Egypt in 2006. After watching the partial phases, with stray beams of sunlight reflecting into his eyes from the glittering sand and sea, McClean was snowblind throughout the totality.

Now he swears by a new method: blindfolding himself throughout the first phases of the eclipse to maximize his experience of the totality. He says he doesn’t mind “skipping the previews if it means getting a better view of the film.” Afterward, he pops on some eye protection to see the partial phases of the eclipse as the moon pulls away from the sun. If you do blindfold yourself, just remember to set an alarm for the time when the total eclipse begins so you don’t miss its cross-country journey. You'll have to wait 28 years for your next chance.

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The Coolest Meteorological Term You'll Learn This Week
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Two tropical cyclones orbiting around each other in the northwestern Pacific Ocean on July 25, 2017.
RAMMB/CIRA

What happens when two hurricanes start to invade each other's personal space? It's easy to picture the two hurricanes merging into one megastorm that tears across the ocean with twice the fury of a normal storm, but what really happens is less dramatic (although it is a beautiful sight to spy on with satellites). Two cyclones that get too close to one another start to feel the pull of a force called the Fujiwhara Effect, a term that's all the rage in weather news these days.

The Fujiwhara Effect occurs when two cyclones track close enough to each other that the storms begin orbiting around one another. The counterclockwise winds spiraling around each cyclone force them to participate in what amounts to the world's largest game of Ring Around the Rosie. The effect is named after Sakuhai Fujiwhara, a meteorologist who studied this phenomenon back in the early 1900s.

The extent to which storms are affected by the Fujiwhara Effect depends on the strength and size of each system. The effect will be more pronounced in storms of equal size and strength; when a large and small storm get too close, the bigger storm takes over and sometimes even absorbs its lesser counterpart. The effect can have a major impact on track forecasts for each cyclone. The future of a storm completely depends on its new track and the environment it suddenly finds itself swirling into once the storms break up and go their separate ways.

We've seen some pretty incredible examples of the Fujiwhara Effect over the years. Hurricane Sandy's unusual track was in large part the result of the Fujiwhara Effect; the hurricane was pulled west into New Jersey by a low-pressure system over the southeastern United States. The process is especially common in the northwestern Pacific Ocean, where typhoons fire up in rapid succession during the warmer months. We saw a great example of the effect just this summer when two tropical cyclones interacted with each other a few thousand miles off the coast of Japan.

Weather Channel meteorologist Stu Ostro pulled a fantastic animated loop of two tropical cyclones named Noru and Kulap swirling around each other at the end of July 2017 a few thousand miles off the coast of Japan.

Typhoon Noru was a small but powerful storm that formed at about the same latitude as Kulap, a larger but much weaker storm off to Noru's east. While both storms were moving west in the general direction of Japan, Kulap moved much faster than Noru and eventually caught up with the latter storm. The Fujiwhara Effect caused Typhoon Noru to stop dead in its tracks, completely reverse its course and eventually perform a giant loop over the ocean. Typhoon Noru quickly strengthened and became the dominant cyclone; the storm absorbed Kulap and went on to become a super typhoon with maximum winds equivalent to a category 5 hurricane.

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