Surgery stories

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Maria
Siemionow

Transplantologist for special tasks

Ambitious Polish woman

Born in 1950 in Krotoszyn, in her childhood Maria Kusza had a plan for her life – she planned to win the Peace Race. For many years, she wanted to follow her father’s path and become a professional sportswoman. As a teenager, she did not suspect that in the future she would make a major breakthrough in transplantology. Only towards the end of her secondary school, she decided to study medicine, combining her biological and humanistic interests. It is not unlikely that her sports training of many years facilitated her studies at the Karol Marcinkowski Medical Academy in Poznań – she was always ambitious, persistent and liked to learn new things. She combined the intense work at the studies with her curiosity to discover the world, that is why she travelled to Ireland, Belgium or Spain. Following graduation, she gained her first professional experience in the Rehabilitation and Surgery of Hand Clinic at the Medical Academy in Poznań. She soon became interested in microsurgery, especially the above mentioned had surgery, as well as transplantology, the arcana of which she explored with the best specialists in the world. It is worth mentioning that she was the only woman in the team.

During her internship in Helsinki, she participated in one of her first crucial operations of reattaching a woodcutter’s hand, cut off by a mechanical saw. In many interviews, Siemionow mentioned that it was a miracle for her. Surely, the day of the described operation turned out to be a breakthrough in her career, since her dissertation describing the operation opened her way to the United States.

The US and the first face transplant

While practising in Louisville, Kentucky, professor Siemionow started her adventure with transplantation microsurgery. She was lucky to go, at once, to one of the best centres for microsurgery and hand surgery in the US. For many years, she gained experience as a surgeon, but also as a scientist, conducting her own research in microcirculation on rats. In 1995 he took up a permanent position in Cleveland, Ohio, where – apart from her practice as a surgeon – she focused on studies on transplants tolerance. However, the popularisation of transplantologic operations was not so easy, since this domain of medicine had already been developing and it was ill-famed for its failures and high mortality rates.

The breakthrough moment came in 2008. Connie Culp, an American citizen, shot in face by her husband in 2004, could not breathe, eat or speak on her own since the accident. Her life was completely changed by professor Siemionow, who – together with her team – conducted the first complete face transplant in the US. Though it was not the first operation of such type in the world, none of the previous ones had covered such a big area of the skin. The operation lasted for almost a whole day and included restoration of vascularity, innervation, musculature and many other anatomic elements – the techniques that Siemionow improved during many years of her experience in crucial studies. The transplant proved to be successful, and the patient functions independently as per today. The professor did not expect, for sure, how great the breakthrough in medicine it would become and how here further career would look like. Until present, the doctor has been managing the plastic surgery and microsurgery ward in Cleveland where the innovative operation took place.

Microsurgery

When mentioning the spectacular success of the crucial face transplant, professor Siemionow repeatedly emphasised her long-lasting experience in the field of microsurgery. The operation itself, from the technical perspective, was described by her as a ‘tissue composite transplant’, which depicts its extent. Since during the operation, the participating surgeons had to secure various connections of tissue elements, such as muscles, skin, vessels, nerves, salivary glands or lymph nodes. The microsurgical methods themselves require an enormous effort during the stump and transplanted part preparation stage. In order to distinguish between the individual elements, various methods are used. for instance, veins are marked with needles threading short pieces of surgical stitches. Arteries are marked with longer fragments. Nerves should be marked differently. Structures marked like that are easy to identify, when they are placed close to each other within the operating field.

Her way from the first contacts with surgery in the Polish operating theatre to year 2008 and the full face transplant in Cleveland was burdened with years of sacrifice and hard study. With no access to any simulators and sets for stitching practice, young Siemionow acquired her skills, laboriously sewing anatomical preparations, or pig’s feet bought in a butcher’s shop. Later, she conducted studies on rats and then devoted to a complicated microsurgical practice in the United States. The years of perseverance, however, led her to the top.

Patriot and model to be followed

Maria Siemionow is an indisputable authority in the field of transplantation and plastic surgery, as well as an exceptionally honest, persistent and determined woman. In spite of her extraordinary fame in the United States, she still remains connected with Poland and the Medical University in Poznań, where she gives lectures for students every year. She comes to Poland for conferences and symposiums. She repeatedly emphasised that her education in Poland was crucial, since there she acquired the basic medical education at a high level. Nevertheless, she admits that the majority of her skills and knowledge in the field of transplantology and microsurgery was gained during many years of practice all over the world. That is why, she is an ardent advocate of scientific exchanges, systematically enabling Polish graduates of medical universities serve their internship in her clinic in Cleveland. She is one of just few women and doctors who were granted a honoris causa title. She received the title for her outstanding achievements in the fields of transplantology, transplant immunology and microsurgery. A honourable award was also the Order of Merit of the Republic of Poland, granted to her in 2009 for “outstanding achievements in the field of plastic surgery, for merits in scientific and research work”. The professor herself, however, still looks forward into the future and sets up more and more difficult goals. While continuing her own research, she is currently conducting works on new immunosuppressive medicines, which could be better tolerated by transplant recipients. She is also interested in the role of chimeric cells in transplantations. A chimeric cell means a fusion of cells originating from a donor and a recipient. Their popularisation should help to minimise the percentage of transplant rejections. Though she does not mention it herself, the scientists who are watching her career, has talked about the achievements worth the Nobel prize.

Professor Siemionow is, for sure, an authority for many students and young doctors. Because of her perseverance and hard work, she became a truly historic figure in the history of medicine. What advice could she give to aspiring scientists and surgeons? In her biography, perseverance and passion for the profession are, for certain, the most striking features. Professor also shows great ambitions and curiosity for the world, which enabled her to gain her international experiences, often against all odds. However, it must be remembered that the times when she acquired her education were not the easiest. In many interviews, Siemionow underlines that it is worth to find one’s own path and a narrow specialisation, in which one may become the best. She recalls a story from her childhood, when she – as a small girl – was bewildered with the amount of knowledge presented in encyclopaedia and realised that it was not possible to get to know everything. However, she always realised that she would like to be the best in her domain and this is her ambition and the goal that led her so high.

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