Robert Chelsea lost his lips and part of his nose and left ear when his car was struck by a drunk driver and exploded in flames on a Los Angeles freeway in 2013. He was burned over 60 percent of his body, and underwent more than 30 surgeries to graft skin to his shoulders, arms, and fingers.
Because his lips were missing, Chelsea had to tilt his head back to swallow food and use a syringe to squirt liquids into the back of his throat. His teeth were exposed, putting him at risk for gum disease and tooth loss.
On Thursday, Brigham and Women’s Hospital announced a turning point for Chelsea, 68, saying he had become the first black patient and the oldest to receive a full facial transplant.
Chelsea had to wait a year and a half to find a face that would match his skin tone, and donor advocates hope his experience encourages more people of color to become organ donors.
“He came out with a beautiful face,” said his godson, Everick Brown, who was with Chelsea during the surgery. “He’s looking pretty darned good.”
Chelsea underwent the 16-hour surgery in July that involved a team of more than 45 physicians, nurses, anesthesiologists, residents, and research fellows. He returned home to Los Angeles earlier this week.
Brown said his godfather is looking forward to regaining enough control of his lips to be able to once again drink and eat normally, and kiss his daughter, Ebony, 29.
“He’s doing very well, and I think he’s excited,” Brown said, adding that he considers his godfather’s transplant and recovery “literally a miracle.”
Chelsea’s year-and-a-half wait for a face was longer than the previous 14 patients who had the operation performed at the Brigham, where the average wait is four to six months.
The donor, who lived out of state and died unexpectedly, is anonymous, but Brown said Chelsea has expressed an interest in meeting the man’s family.
“May God bless the donor and his family who chose to donate this precious gift and give me a second chance,” Chelsea said in a statement. “Words cannot describe how I feel. I am overwhelmed with gratitude and feel very blessed to receive such an amazing gift.”
Chelsea’s milestone as the first black recipient of a full facial transplant comes after another black patient in Paris received a partial face transplant in 2007.
Donor advocates have pointed to Chelsea’s story to underscore the challenge of finding nonwhite donors for facial and hand transplants.
“It is vitally important for individuals of all races and ethnicities to consider organ donation, including the donation of external grafts, such as face and hands,” Alexandra Glazier, president and chief executive of New England Donor Services, said in a statement. “Unlike internal organs, the skin tone of the donor may be important to finding a match.”
African-Americans last year accounted for 13 percent of the 17,554 organ donations in the United States — about equal to their proportion of the population.
But they make up about 29 percent of Americans on the waiting list for an organ. Doctors have said the need for certain organs is greater among African-Americans, in part because they are more likely to suffer from high blood pressure and other diseases that can lead to kidney failure.
Chelsea was placed on the list of patients waiting for a facial transplant in March 2018, and seemed to be on the fast-track for a match when a black family came forward with a potential donation two months later.
But the donor’s skin was lighter than Chelsea’s, and he didn’t like the idea of becoming “a totally different-looking person,” he told Time magazine.
That left Chelsea to wait until this summer for another black donor.
“Can we imagine all the others that we have walked away from, or avoided,” Chelsea, referring to the social stigma disfigured patients may face, said in a video interview from his hospital bed, recorded by the Brigham before his surgery. “That is why donor participation is so very vital — because there are so many people who could live a normal life and have the reception of others that they just can’t have now.”
Brigham officials said studies of previous facial transplant recipients indicate Chelsea is likely to regain close to normal sensation in his face and about 60 percent of his motor function within a year, including the ability to eat, smile, and speak normally.
Still, doctors have said they can’t predict how long face transplants will last. In some cases, recipients’ immune systems reject a donor face.
“So far, [Chelsea has] had no major setbacks and he continues to progress well,” said Dr. Bohdan Pomahac, who led Chelsea’s facial transplant surgery. “We were honored we were able to help Robert, who is a wonderful person.”