A 55-year-old man from Austin, TX, has become the first person to undergo a partial skull and scalp transplant, performed simultaneously alongside kidney and pancreas transplants.

Share on Pinterest James Boysen has become the first person to undergo a skull-scalp transplant.

Image credit: Associated Press

A 50-strong team led by Dr. Jesse C. Selber, of the MD Anderson Cancer Center at the University of Texas, and Dr. A. Osama Gaber, of the Houston Methodist Hospital, TX, performed the complex surgery, which took 24 hours to complete in total.

Software developer James Boysen was diagnosed with leiomyosarcoma – a rare cancer of the smooth muscle tissue – on his scalp in 2006.

Though Boysen underwent successful chemotherapy and radiotherapy for the cancer, the treatment severely damaged his scalp tissue, leaving a 10-by-10-inch wound that descended through the skull to the brain.

Boysen’s kidney and pancreas were also found to be failing. Both of these organs were first transplanted in 1992 as a result of damage caused by diabetes, which he had been diagnosed with at the age of 5.

As a result, Boysen required reconstructive surgery on his scalp, as well as kidney and pancreas transplants. This presented a challenge for surgeons; the skull and scalp wound were stopping them from performing the kidney and pancreas transplants, while Boysen’s organ failures and the immunosuppressive medications he was taking posed difficulties for scalp reconstruction.

However, Dr. Selber came up with a novel idea 4 years ago that would allow all the required surgery to go ahead.

“When I first met Jim, I made the connection between him needing a new kidney and pancreas and the ongoing antirejection medication to support them, and receiving a full scalp and skull transplant at the same time that would be protected by those same medications,” Dr. Selber explains.

“This was a truly unique clinical situation that created the opportunity to perform this complex transplant.”