Surgical teams at Houston Methodist Hospital and The University of Texas MD Anderson Cancer Center worked hand-in-hand with LifeGift to create history in the Texas Medical Center on Friday, May 22, 2015.
The teams worked together to successfully recover and transplant, for the first time, a scalp and skull, while simultaneously recovering and transplanting a kidney and a pancreas. The donor was registered on the Donate Life Texas Registry.
James Boysen, a 55-year-old software developer from Austin, Texas, was the recipient of these gifts. Diagnosed in 2006 with leiomyosarcoma, a rare cancer of the smooth muscle on his scalp, Mr. Boysen was left with a large, deep wound on his head that included the scalp and full thickness of his skull down to his brain. At the same time, his kidney and pancreas were failing as a result of his diabetes, which he developed at age 5.
“While it was exciting to be part of something never done before, the more fulfilling part of this was knowing that Mr. Boysen would receive a gift that would change his life so much,” said Jocelyn Cooper, supervisor of organ preservation services in LifeGift’s Southeast region, who helped lead the extremely complex recovery. “Not all cases make history like this one, but they all create a lasting impact – a legacy of life and hope, and that’s what I find so rewarding.”
The transplant was considered a vascularized composite allograft (VCA), which involves the transplantation of multiple structures that may include skin, bone, muscles, blood vessels, nerves and connective tissue.
While VCAs are becoming an emerging part of the donation and transplantation field, state donor registries, such as the Donate Life Texas Registry, do not provide an opportunity to specifically authorize VCAs for procurement. Explicit consent for VCAs from prospective donors (or next of kin) must be as clear and meaningful as possible and separate from the authorization provided on the registry for solid organs.