Teams of surgeons headed by McGowan Institute for Regenerative Medicine faculty member W. P. Andrew Lee, MD, professor of surgery and chief of plastic surgery at the University of Pittsburgh School of Medicine, Division of Plastic and Reconstructive Surgery, have performed a single- and a double-hand transplant on two patients. Dr. Lee is one of the leading hand surgeons and researchers in the world.
The first patient, a Marine who was hurt in a training accident, had some movement in his fingers less than 10 days following the single-hand transplant. He will undergo intense daily physical therapy for 3 months to fully restore movement in his new hand.
The second patient is a former Air Force member who lost both hands and both feet to a sepsis infection a decade ago. It took 9 hours and 4 teams of surgeons to perform his double-hand transplant. The patient’s amputations were partway up his forearms, and surgeons attached the donor's hands and lower forearms to his arms after carefully labeling all the tendons, nerves, and muscles that would be attached to each other.
The transplants were done as part of a study that uses what's called the Pittsburgh Protocol, which has been used in some organ transplants at UPMC. The Pittsburgh Protocol uses three elements to avoid rejection — treating the patient with antibodies on the day of transplant, performing a donor bone marrow infusion several days later, and using one anti-rejection drug instead of the traditional three. Some of the side effects of the latter drugs include diabetes and high blood pressure.
“We think we have the potential of accomplishing composite tissue transplants with fewer medications than have been used previously,” Dr. Lee said. “We think this is very important because these transplants don't save any lives but improve the quality of life.”
More than 32 patients have received hand transplants worldwide. The first U.S. recipient — who underwent surgery about 10 years ago in Louisville — is the longest surviving hand transplant recipient in the world. In support of the research required to achieve safe and efficacious hand transplantation, Dr. Lee visited and examined 11 of the 14 patients who have had confirmed hand transplants since 1998 and was the principal author of a position paper by the American Society for Surgery of the Hand, which guides physicians and researchers throughout the world on the ethics of proceeding with hand transplantation.
The UPMC Department of Surgery is one of the leading surgical programs in the country, offering innovative surgical procedures, state-of-the-art technology, and high-quality patient care. Working closely with the Department’s academic partner, the University of Pittsburgh School of Medicine, the department’s surgeons pioneer and refine surgical procedures to provide leading-edge, compassionate care to patients who require surgical services in a wide range of specialties. The department is composed of eight divisions.