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Entries in Arm (2)

Wednesday
Sep122012

Texas Woman to Receive Nation’s First Double Arm Transplant

Keith Brofsky/Thinkstock(BOSTON) -- Surgeons at Brigham and Women’s Hospital in Boston will perform the nation’s first double arm transplant on a Texas woman, the hospital announced Wednesday.

Katy Hayes, 44, a quadruple amputee and mother of three from Kingwood, Texas, has been approved for the transplant after undergoing rigorous evaluation.

In 2010, Hayes, a former massage therapist, developed a flesh-eating bacterial infection after giving birth to her third child. To keep her alive, doctors had to amputate her arms above the elbow, her legs above her knees, her uterus and her large intestines.

“I never thought about how much a gift your hands are,” Hayes said at a news conference Wednesday. “I have to be baby-sat, which is ridiculous.”

More than 48 patients worldwide have received hand and arm transplants. In 2009, the University of Pittsburgh Medical Center performed the nation’s first bilateral hand transplant.

An above-the-elbow arm transplant similar to Hayes’ proposed procedure has previously been performed in Munich, Germany, by Dr. Christoph Hoehnke.

The procedure will involve a team of 40 medical experts, doctors said at the news conference.

The transplant will connect skin, muscle, bones and blood vessels on both arms. While the surgery will repair the appearance of her arms, doctors are not sure whether full function of the arms will be restored.

Unlike internal organ transplants, hand and arm transplants not only depend on connecting the blood supply, but also on nerve regrowth for the arm to function normally, according to Dr. Vijay Gorantla, administrative medical director of the Pittsburgh Reconstructive Transplant Program at University of Pittsburgh Medical Center.

Nerves regrow about one millimeter a day, said Gorantla, who is not involved in Hayes’ transplant, but was on the earlier double-hand transplant team.

“The recipient nerves have to regrow in the donor shell,” said Gorantla, adding it could take years, if it happens at all. “At this point, there’s no technology to expedite that growth.”

“Theoretically, there’s a risk that these patients may not be functional or as functional as a distal hand transplant,” he said.

Research on hand and arm transplants has grown since the first transplant. Transplant patients often take multiple high-dose medications to prevent tissue rejection. Researchers at Johns Hopkins Medicine are researching ways to cut the number of high-dose drugs taken.

In a current study, Johns Hopkins researchers are treating patients with antibodies on the day of the transplant, followed by a bone marrow infusion after the transplant. Patients are then able to be treated with a single, lower-dose medication.

Doctors did not clarify Hayes’ post-transplant recovery plans, but said the process to recovery will be a long one.

“I want my life back,” said Hayes. “I want to hold my children. I want to hug my husband.”

Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham and Women’s Hospital, the same pioneering surgeon who performed total face transplants to patients including Dallas Weins and Charla Nash, will be among Hayes’ surgical team.

Brigham and Women’s is working with the New England Organ Bank, a New England-based organ procurement organization, to find Hayes a donor.

Copyright 2012 ABC News Radio

Friday
Oct282011

Man’s Severed Arm Kept Alive with His Leg Artery

Keith Brofsky/Thinkstock(DALLAS) -- A Texas man is happy he can hold is grandchildren again after an experimental surgery to reconnect his severed arm, reports WFAA in Dallas.

In late August, Royce Reid, 49, was injured in an accident at work, which severed his left arm. It took hours to transfer him and his arm from a hospital in Longview, Texas, to Parkland Memorial Hospital in Dallas, and on the trip, the Navy veteran nearly bled to death.

Dr. Bardia Amirlak, the University of Texas Southwestern plastic surgeon who was on call at the Parkland trauma center when Reid arrived, said that the long trip lowered the chances that Reid’s arm would be successfully reattached.

“When the muscles start to die, you cannot put the arm back on,” he told WFAA.

Although it had been seven hours since Reid’s arm was severed, Amirlak decided to try to give Reid his arm back. In an experimental procedure, Amirlak used blood from Reid’s own leg to restore oxygen to the amputated arm.

“We hooked a tube up to the artery in leg, and took it outside his body and transfused it directly into his arm to keep it alive,” Amirlak explained to WFAA. “We did that while we are working on his bones and the blood vessels to keep the muscle alive.”

Two months later, Reid is undergoing rehabilitation and is gradually regaining the use of his hand.

To reattach severed limbs, doctors perform microsurgery, a form of plastic surgery in which they reconnect bone, muscles, nerves and blood vessels. The delicate operation takes hours, and patients must go through months of rehabilitation to regain feeling and use of their limbs.

Dr. Ben Chang, an associate professor of surgery at the University of Pennsylvania, said that’s because the nerves in the limb can’t simply be reconnected -- they must regrow.

“The nerves have to grow all the way out,” Chang said. “Nerves grow at about an inch per month. So if you cut off your arm at the forearm, it may take 10 months before the nerves grow all the way back down to the hand.”

According to a report in Wired magazine, the first successful human limb reattachment was in 1962, when Boston surgeons put a 12-year-old boy’s arm back on after it was severed when he was trying to hop a freight train. In the 1980s, surgeons started using microscopes to help them see the tiny structures they were trying to connect in severed limbs, a major advance in the field.

Dr. Chang said the surgical techniques used to reconnect severed limbs are similar to those used in the past decade for transplants of hands, faces, and other body parts. In October, a Massachusetts man became the latest patient to get a double hand transplant. In 2010, a Spanish man became the first person to have a full face transplant.

Copyright 2011 ABC News Radio







ABC News Radio