Success! Texas Man Gets World’s First Skull And Scalp Transplant

James Boysen, a 55 year-old software engineer, underwent nearly 24 hours of surgery performed by more than 50 medical professionals to become the first recipient of a skull and scalp transplant — and an unintentional hair transplant at the same time – apart from receiving kidney and pancreas transplant at Houston Methodist hospital on 22 May.

“James Boysen is the first patient to receive the simultaneous craniofacial tissue transplant together with solid organ transplants,” Houston Methodist Hospital said in a statement. A number of patients across the world have received artificial skull grafts in the past, but this is the first using a human donor.

The operation was very complex because tissues had to be transplanted through microsurgery. Lead surgeon Michael Klebuc said, “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.”

“I’m amazed at how great I feel and am forever grateful that I have another chance to get back to doing the things I love and be with the people I love. It’s kind of shocking, really, how good they got it. I will have way more hair than when I was 21,” Boysen said after he was discharged from the hospital on June 4.

“For this patient, it means a new lease on life. He had series of cancers of the scalp and skull that were treated with various surgeries and radiation that left him with a large wound that was all the way down to his brain,” said Jesse Selber, a reconstructive plastic surgeon, the co-leader of the team that performed the intricate surgery.

All of the organs, tissue and bone came from the same donor. “I’m glad the donor family had the generosity and insight to approve us doing this, to get through their grief and approve the donation of this tissue besides the organs,” said A Osama Gaber, transplant chief at Houston Methodist.

Boysen developed leiomyosarcoma, a rare form of cancer that attacks the smooth muscles under the scalp, after undergoing a first kidney-pancreas transplant in 1992. The effects of the radiation treatment left his skull and scalp severely damaged. As a result, his transplanted organs started to fail.

“I couldn’t get the transplant for my organs without fixing my scalp, and I couldn’t fix my scalp without the transplant for the organs so it was a Catch-22,” he said at a news conference.

So doctors concluded in 2011 that the only solution was to replace everything at once. On 22 May, Boysen’s scalp and skull were replaced with a 10-by-10-inch skull graft and a 15-inch-wide piece of skin for an operation that lasted 15 hours. The next 8 hours were spent in transplanting Boysen’s pancreas and kidneys.