Eduardo D. Rodriguez,
University of Maryland: Richard Lee Norris Receives Most Extensive
March 28, 2012
The University of Maryland Medical Center has performed the most
extensive full-face transplant completed to date, including teeth, both
jaws, and tongue.
The face transplant, formally called a vascularized composite allograft
(VCA), was part of a 72-hour marathon of transplant activity.
The face transplant team was led by Eduardo D. Rodriguez, M.D., D.D.S.,
associate professor of surgery at the University of Maryland School of
Medicine and chief of plastic, reconstructive and maxillofacial surgery
at the R Adams Cowley Shock Trauma Center at the University of Maryland
“We utilized innovative surgical practices and computerized techniques
to precisely transplant the mid-face, maxilla and mandible including
teeth, and a portion of the tongue. In addition, the transplant included
all facial soft tissue from the scalp to the neck, including the
underlying muscles to enable facial expression, and sensory and motor
nerves to restore feeling and function,” explains Dr. Rodriquez. “Our
goal is to restore function as well as have aesthetically pleasing
The face transplant recipient, 37-year-old Richard Lee Norris of
Hillsville, Virginia, was injured in 1997 in a gun accident. Since that
time, he has undergone multiple life-saving and reconstructive
surgeries. Due to the accident, Mr. Norris lost his lips and nose and
had limited movement of his mouth. Mr. Norris first came to the
University of Maryland Medical Center in 2005 to discuss reconstructive
options with Dr. Rodriguez.
Grant funding from the Office of Naval Research (ONR) in the Department
of Defense to Dr. Stephen Bartlett has supported the University of
Maryland basic and clinical research program in vascularized composite
transplantation leading up to and supporting this groundbreaking face
Lee Norris before surgery (Credit: University of Maryland)
The ONR funds medical research to support military operational medicine
and clinical care of returning veterans. In addition to conducting
research, the University of Maryland supports military medicine in a
variety of ways, including training military medical staff prior to
deployment and performing organ transplant surgeries for patients at
Walter Reed/Bethesda National Naval Medical Center.
“The future of medicine depends on rapid translation of research and
creating high-performing teams. The face transplant is a perfect example
of the life-changing options we can provide for our patients when we
combine the expertise of our research and clinical teams to pursue
procedures that would have seemed unfathomable not so long ago,” says E.
Albert Reece, M.D., Ph.D., M.B.A., vice president of medical affairs at
the University of Maryland and dean of the University of Maryland School
The team of face transplant surgeons benefited greatly from their
experience treating high-velocity ballistic facial injuries at the R
Adams Cowley Shock Trauma Center at the University of Maryland Medical
Center. The team also includes research scientists and physician
scientists from the University of Maryland’s nationally recognized
Division of Transplantation who have been researching ways to reduce
rejection of donated organs and minimize the side effects of long-term
immunosuppressive use after transplantation.
Lee Norris after surgery (Credit: University of Maryland)
“A project like the face transplant requires multi-disciplinary
collaboration between numerous clinical services and in many ways is
very similar to trauma care,” says Thomas M. Scalea, M.D., Francis X.
Kelly Professor of Trauma Surgery, director, Program in Trauma,
University of Maryland School of Medicine, and physician-in-chief, R
Adams Cowley Shock Trauma Center.
“Because we have an infrastructure built around multi-disciplinary care,
it made sense for the facial transplant program to be housed at the
Shock Trauma Center in the University of Maryland Medical Center,” he
The scientific team that includes Drs. Stephen Bartlett, Rolf Barth, and
Eduardo Rodriguez focused on the anatomic and immunologic challenges to
craniofacial transplantation. This work has been the basis for Dr.
Rodriguez and his surgical team’s groundbreaking surgical achievement.
“This accomplishment is the
culmination of more than 10 years researching the immune system’s
response to vascular composite allograft transplants,” says Stephen T.
Bartlett, M.D., Peter Angelos Distinguished Professor and Chair of the
Department of Surgery at the University of Maryland School of Medicine
and Surgeon-in-Chief at the University of Maryland Medical Center. “Our
solid organ transplant immunosuppressive protocol has led to excellent
outcomes for our patients and will be part of the long-term care plan
for the face transplant patient.”
face transplant team collaborated with the Living Legacy Foundation of
Maryland, the organ and tissue donation program serving most of
Maryland. The Living Legacy Foundation of Maryland is a non-profit
organization that helps facilitate the donation and recovery of human
organs and tissues for transplantation and research, and provides public
and professional education on organ donation.
“The resources and talent that made this complex organizational effort a
reality was months in the making and touched all areas of the hospital,”
says Jeffrey A. Rivest, president and chief executive officer of the
University of Maryland Medical Center. “The Medical Center staff is
honored to care for patients and families facing such tremendously
complex medical challenges.”