Joe DiMeo's life changed forever when he fell asleep at the wheel on U.S. Route 22 in New Jersey on July 14, 2018.
The horrific crash left him with third-degree burns on 80% of his body and a grim prognosis.
Now, more than two years later, DiMeo, 22, is the recipient of the world's first successful double hand and face transplant, and on the road to recovery.
The historic surgery, which took place on Aug. 12, 2020, at NYU Langone in New York City, involved more than 140 health care professionals.
Over 23 hours, they successfully transplanted two hands, three dominant nerves to the hand, six blood vessels, 21 tendons and a full face, including forehead, eyebrows, both ears, nose, eyelids, lips, and underlying skull, cheek, nasal and chin bone segments.
Face and hand transplants have been performed independently, but this double procedure had been attempted twice before and was unsuccessful both times.
For this procedure, surgeons used computer-generated three-dimensional guides. They ensured that bones were properly aligned and implants were in position to anchor the grafted face and hands to DiMeo.
Technology aside, a big part of DiMeo's success owes to his can-do attitude, according to the head of his surgical team, Dr. Eduardo Rodriguez, director of NYU Langone's Face Transplant Program.
"He is the most highly motivated patient I have ever met," Rodriguez marveled during a media briefing.
And while it hasn't been an easy road, DiMeo told reporters he's "grateful" and doing well.
"I have been able to get back to many activities I love, such as playing with my dog and playing pool," he said. "I can't wait to get back to work."
Reaching this milestone was no easy feat.
DiMeo spends five hours a day in various types of therapy. He is re-learning everything from how to feed and dress himself to how to lift weights and swing a golf club. This video shows his amazing progress:
Of course, things looked bleak after the crash.
DiMeo was pulled out of his car shortly before it exploded, and spent about three months in a medically induced coma.
He underwent 20 reconstructive surgeries, including skin grafts and blood transfusions, before he was referred to NYU Langone for a possible double hand and face transplant.
"He had no ears, no nose, no lips, no eyebrows and severe scarring of neck," Rodriguez recalled. "His hands looked like mittens. They were completely scarred and he had limited range of motion in his wrist and hands."
The injuries also affected DiMeo's sight.
"He was completely dependent on care from his parents to dress him, to bathe him and to feed him," Rodriguez said.
Starting with the search for a suitable donor -- a quest Rodriguez likened to "finding a needle in a haystack" -- the odds seemed arrayed against him.
Because DiMeo had had many blood transfusions and skin grafts after the crash, doctors were mindful that his immune system was more likely to reject any donor organs and tissues.
"There was only a 6% chance of identifying an ideal donor for him, and we had to go beyond New York state lines," Rodriguez said.
After just 10 months, doctors found a donor for DiMeo through Gift of Life, a regional organ donor program serving southern New Jersey, Pennsylvania and Delaware.
Total time from accident to transplant: Just over two years.
In the middle of it all, the coronavirus pandemic intervened.
Just three months after DiMeo was first listed for organ donation, Rodriguez and other doctors had to switch gears to care for COVID-19 patients.
Even so, the transplant team practiced the surgery nearly a dozen times over the course of a year to make sure they got it right when the time came.
So far, DiMeo's body has shown no signs of rejecting his new face and hands. Rodriguez said that's likely due to a new immunosuppression regimen.
Since the transplant, Rodriguez has performed several less extensive follow-up surgeries to improve DiMeo's functional and aesthetic outcomes, and DiMeo is thrilled.
"I am so happy with the results of my transplant," he said.
Visit Organdonor.gov to learn more about organ donation and how to become an organ donor.
SOURCES: Eduardo Rodriguez, MD, DDS, director, Face Transplant Program, professor, reconstructive plastic surgery, and chairman, Hansjörg Wyss Department of Plastic Surgery, NYU Langone, New York City; Joe DiMeo, Clark, N.J., face and hand transplant recipient; NYU Langone media briefing, Feb. 3, 2021