The operation, involving around 100 medical specialists, represents a significant step in transplant medicine and expands the possibilities for complex reconstructive procedures.

Facial disfigurement is one of the most devastating physical disabilities a person can suffer. It not only has a serious psychological and social impact on those affected, but also affects fundamental activities such as speaking, eating, and seeing. 

“A face transplant is a functional surgery carried out when the patient has lost areas of the face such as the orbicular muscles around the eyes and mouth that cannot be restored with usual plastic surgery techniques. It is for patients with severe facial disfigurement caused by disease, burns, trauma, or congenital defects that affect basic vital functions,”

says Dr. Joan-Pere Barret i Nerín, Head of Plastic and Burn Surgery at Vall d’Hebron University Hospital. 

In 2010, the Vall d’Hebron team led by Dr. Barret carried out the world’s first full face transplant, five years after a hospital in Amiens, France, performed the first partial face transplant. The second face transplant at Vall d’Hebron in 2015 was also notable as the first in the world performed under controlled asystole (Maastricht 3 conditions). 

Now, Vall d’Hebron has carried out the world’s first partial face transplant with a donor who received euthanasia. The donor, who had been authorised for PRAM (Medical Aid in Dying), chose not only to donate her organs and tissues, but also offered to donate her face.

“Donors and their families always perform an immense act of generosity and altruism, but this case, moreover, shows a level of maturity that leaves one speechless. Someone who has decided to end their life dedicates one of her last wishes to a stranger and gives them a second chance of this magnitude,” says Dr. Elisabeth Navas, Medical Coordinator of Donation and Transplants at Vall d’Hebron University Hospital. 

The recipient needed a type I face transplant (central part of the face) after suffering facial tissue necrosis from a bacterial infection. 

Vall d’Hebron has performed three of the six face transplants carried out in Spain; internationally, there have been 54 in total.

Only around twenty centres worldwide have the capacity to perform facial transplants, and just seven have done three or more, given the experience and healthcare and laboratory resources required. 

Around one hundred specialists participate in each face transplant, including Plastic and Reconstructive Surgery, Transplant units, Anaesthesiology, Immunology, laboratory teams, Psychiatry and Clinical Psychology, Rehabilitation, Intensive Care, and Pathology, among others. 

Vall d’Hebron is a reference centre for donation and transplants in Spain and, despite having the necessary facilities, follows a tailored protocol for each case. 

Key steps include donor-recipient matching (based on sex, blood group, and compatible facial measurements), 3D imaging to plan surgery, and specialised techniques to ensure reconnection of nerves and tissues for function and expression. 

After the operation, the patient remains in hospital for monitoring, immunosuppression management, and rehabilitation to regain function and expression in the transplanted tissues. Psychological support is also provided. 

The latest recipient is adapting to a new life made possible by the donor’s altruism. 

04.02.2026.