Mr. James Boysen, 55, a software developer from Austin, Texas, underwent the world’s first scalp and skull transplant on May 22, 2015 at Houston Methodist Hospital, Texas, USA. Surgical teams from Houston Methodist Hospital and The University of Texas MD Anderson Cancer Center successfully transplanted a scalp and skull while performing kidney and pancreas transplants. Mr. Boysen is the first patient to receive the simultaneous craniofacial tissue transplant together with solid organ transplants.

In 2006, Mr. Boysen was diagnosed with leiomyosarcoma, a rare cancer of the smooth muscle, on his scalp. It was treated with a combination of chemotherapy and radiotherapy, but the treatment permanently destroyed the surrounding scalp and skull, leaving his brain vulnerable. Normally doctors would use a combination of skin grafts and metal plates or 3D-printing to reconstruct his skull. But he was already on immunosuppression medication after earlier kidney and pancreas transplants in 1992 (he was diagnosed with diabetes at the age of five) which were now failing. His struggling organs, and the medication, were stopping doctors performing the reconstruction and the hole in the skull prevented an organ transplant. Dr. Jesse Selber, who led the team from MD Anderson, said the hole was 10 by 10 inches (25 cm by 25 cm) covering “the entire top half of the head.”

Dr. Selber said that when he first met Mr. Boysen he realised that this was a truly unique clinical situation that created the opportunity to perform a complex transplant – when Mr. Boysen received a new kidney and pancreas transplant and the ongoing anti-rejection medication to support them, he could also receive a full scalp and skull transplant at the same time that would be protected by those same medications. The surgeons had the idea to combine the operations four years ago, but had to wait for a donor. Dr Selber said that Mr. Boysen’s “patience, courage and enthusiasm for the idea were vital” to the success of the procedure.

Mr. Boysen was discharged from the hospital less than two weeks after the surgery. He said, “This has been a long journey, and I am so grateful to all the doctors who performed my transplants. 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.”