Barcelona hospital carries out world’s first face transplant with a donor who was euthanized

Vall d’Hebron University Hospital in Barcelona has performed the world’s first face transplant with a donor who passed away from euthanasia.

Around 100 medical professionals took part in the partial face transplant, a highly complex operation using neurovascular microsurgery techniques that lasted about 24 hours.

In presenting the milestone procedure, the healthcare director, Maria José Abadías, highlighted the “extraordinary generosity of the donor,” ​the “collective effort” behind the operation and the “pride” of all workers who took part in it.

Vall d’Hebron has performed three of the six facial transplants ever performed in Spain. Worldwide, only 54 have been performed, at around twenty transplant centers.

The transplant presented on Monday was the first performed with a donor who died though euthanasia. 

“I am here today to say thank you,” Carme, the woman who received the face transplant, said at a press briefing on Monday morning.

After suffering necrosis of facial tissues due to a bacterial infection two years ago, she was forced into intensive care. When she came out, she found that she could not eat or breathe properly, eventually resulting in her receiving the transplant. 

“Now my life is starting to get a little better," she explained. "After four months, I can talk, I can eat, I can drink again.” 

Face transplantation is a surgery that is carried out when the patient has lost areas of the face such as the orbicularis oculi muscles, the eyes, and cannot be restored with other common surgical techniques of plastic surgery.

"A transplanted face that does not feel or move is nothing more than a mask. We are talking about structures with all types of tissues, with muscles and nerves, some with diameters of 0.2 millimeters, which must be found and connected,” Dr. Joan-Pere Barret, head of the Plastic Surgery and Burns Service at the Vall d’Hebron Hospital, explained.

Euthanasia donation

The euthanasia law in Spain, which came into force in June 2021, opened up a new possibility for transplants.

In the case of this transplant, as the donor had received prior authorization, medical workers could do more planning than usual.

The transplant was also the first in the world in which 3D planning could be done on both the donor and the recipient.

The donor was a woman who had requested euthanasia and who had expressed her desire to be a donor, also of the face if necessary.