Curtis National Hand Center Surgeons Perform Innovative Double Arm Transplant

Jan 29, 2013, 20:48 ET from MedStar Health

BALTIMORE, Jan. 29, 2013 /PRNewswire-USNewswire/ -- Surgeons from the Curtis National Hand Center at MedStar Union Memorial Hospital, led by its chief, James P. Higgins, MD, have performed their first double arm transplant on a 26-year old Iraq war vet.

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The recipient, Brendan Marrocco from Staten Island, was 22 when he lost all four limbs during a roadside bomb explosion in 2009.  He is the first quadruple amputee to have survived that level of trauma.

It's that fighting spirit, say surgeons, which led to him being selected for the 12-hour bi-lateral transplant surgery December 18th.  His is only the seventh successful double arm transplant in the United States.

The transplant was a collaborative effort, performed at Johns Hopkins with teams led by W.P. Andrew Lee, MD, Director of the Department of Plastic and Reconstructive Surgery for Johns Hopkins Medicine, and Patrick Basile, MD, Lieutenant Commander in the US Navy at Walter Reed National Military Medical Center.

The transplants — a process involving the connection of bones, blood vessels, muscles, tendons, nerves and skin on both arms — required an innovative treatment to prevent rejection of the new limbs. With an infusion of the deceased donor's bone marrow cells, the treatment has effectively prevented rejection and has reduced the need for anti-rejection drugs. Donor arms were attached just above the elbow on one side, and just below the elbow on the other.

Marrocco's surgeons project his nerves will regenerate at a rate of one inch per month. Only five weeks out of surgery, doctors say any efforts to attempt movement need to be restrained.  It will take nearly 18 months before he has visible function.  But even without sensation in his fingers, Marrocco uses his new hands to text, scratch his face and do his hair.  He is eager to do more as the slow-growing nerves and muscles mend. Specifically, he said, "I can't wait to drive."

"Our group here in Baltimore," Dr. Higgins told a crowded press conference Tuesday, "in collaborating with Dr. Lee's team and Dr. Jaimie Shores' team for the last 18 months, and working together through the technical aspects of this operation, through multiple rehearsals, have come up with what I would think, is the most advanced procedural aspects that bilateral hand transplantation has seen thus far.

"But I think, as much as we can work on all the technical details and the perfecting the medications that the patient will receive afterwards, and try honing down all those things to what we consider perfection, ultimately, the result is going to be determined by the patient, and also the support of his family.

"That's really the reason why most of us, as the surgical team, are so enthusiastic and so optimistic about Branden's prognosis because he's certainly determined."

Marrocco will continue to undergo extensive psychical therapy, including daily six-hour sessions of hand therapy for at least the next two years. The progress will be slow as Marrocco works towards reaching full capacity of function, but the outcome is expected to be positive.

"I feel great. I'm doing a lot better now," said Marrocco. "It gives me a lot of hope for the future."

For more information about the Curtis National Hand Center, or a physician referral, call:  877-UMH-HAND (877-864-4263).

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SOURCE MedStar Health