MD Anderson collaborates on world’s first skull-scalp transplant

Doctors from MD Anderson and Houston Methodist Hospital have performed what is believed to be the world’s first partial skull and scalp transplant on a man whose treatment for a rare cancer of the scalp muscle left him with a deep head wound.

During the same surgery, the patient also received a donor kidney and pancreas.

“This has been a long journey, and I am so grateful to all the doctors who performed my transplants,” said James Boysen, a 55-year-old software developer from Austin, Texas. “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.”

Boysen’s first kidney-pancreas transplant was in 1992, to treat diabetes he’s had since age 5. The immune suppression drugs he took to prevent organ rejection raise the risk of cancer, and he developed leiomyosarcoma, a rare type of cancer affecting the smooth muscle under his scalp.

Radiation therapy for the scalp cancer left Boysen with a large head wound, and the immune suppression drugs kept his body from repairing the damage. In addition, the transplanted organs he received 23 years ago were starting to fail.

Yet doctors could not perform a new kidney-pancreas transplant as long as he had an open wound.

Jesse Selber, M.D., a reconstructive plastic surgeon at MD Anderson, conceptualized a solution – give Boysen a new partial skull and scalp, a new pancreas and a new kidney, all at once.

“When I first met Jim, I made the connection between him needing a new kidney and pancreas and the ongoing anti-rejection medication to support them, and receiving a full scalp and skull transplant at the same time that would be protected by those same medications,” Selber said. “This was a truly unique clinical situation that created the opportunity to perform this complex transplant.”

The surgery took place on May 22 at Houston Methodist Hospital. A team of about a dozen doctors and 40 health care professionals participated, led by Selber and Houston Methodist’s A. Osama Gaber, M.D., director of the Houston Methodist J.C. Walter Jr. Transplant Center.

LifeGift, a Houston-based organ procurement agency, procured the organs for transplant.

Boysen was discharged from the hospital June 4, and will remain in Houston for three weeks of follow-up care from both institutions.

Last year, doctors in the Netherlands replaced most of a woman's skull with a 3-D printed plastic one. The Texas operation is the first skull-scalp transplant from a human donor.

Read the full press release on the MD Anderson website.