Entries in Limbs (2)


Turkish Doctors Almost Succeed in First-Ever Four-Limb Transplant

Keith Brofsky/Thinkstock(ANKARA, Turkey) -- Sevket Cavdar, 27, was almost the first person in the world to undergo a successful transplant of two arms and two legs at Hacettepe University Hospital in Ankara, Turkey, on Friday.

But hopes were dashed on Monday when doctors had to amputate all four of the transplanted limbs because of  “metabolic complications,” according to a statement from the hospital.

The hospital said Cavdar was currently in the hospital’s intensive care unit but offered no further details about his condition, according to a report from Agence France-Presse.

Cavdar lost all four of his limbs in 1998 after he was accidentally electrocuted.

The hospital announced on Saturday that the 20-hour operation by a team of 52 doctors had succeeded, and Dr. Murat Tuncer, the lead surgeon, called for blood donations to avoid possible complications after the surgery.  Then, doctors had to remove one leg when Cavdar’s heart and vascular system failed to sustain it.  The amputation of the other limbs followed shortly thereafter.

Dr. L. Scott Levin, president of the American Society of Reconstructive Transplantation, told ABC News that it’s likely that Cavdar went into shock after the attached limbs were deprived of adequate blood supply and began releasing metabolites in his body that damaged his circulation.

“In these cases, it’s life before limb.  You have to amputate the limbs to save the patient’s life,” said Levin, who was not involved in the Turkish operation.

Levin explained that limb transplantation was an exceedingly complicated process that required precise coordination, careful rehearsals and contingency plans for things that could go wrong.  When he and a team at the Hospital of the University of Pennsylvania performed a transplant of two hands in 2011, it took almost 20 doctors and two years of planning to ensure the success of the operation.

Limb transplantations are not only difficult for doctors to plan but extremely taxing for patients.  Levin said the attempt to give Cavdar four new limbs was particularly bold.

“In these transplants, there may be a threshold that we cross in terms of how much of a burden we put on a patient when we try to do more than one limb at a time,” Levin said.  “Perhaps the limit is two extremities and perhaps not more.”

Copyright 2012 ABC News Radio


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