Child becomes first ever to receive double hand transplant

A Baltimore-area boy who had lost his hands and feet due to a severe infection when he was two years old has become the first-ever recipient of transplanted donor hands and forearms, receiving the new appendages during a 10-hour procedure completed earlier this month.
The operation, which was only just announced this week, took place at the Children’s Hospital of Philadelphia and required a 40-member team of doctors, nurses and surgeons, CBS News and the Associated Press (AP) reported on Tuesday. The now eight-year-old patient, Owings Mills native Zion Harvey, said that waking up with new hands felt ‘‘weird at first, but then good.’’
During the procedure, which was led by Dr. L. Scott Levin, head of the department of orthopedic surgery at Penn Medicine and director of the Children’s Hospital hand transplantation program, the donor’s hands and forearms were attached by connecting bone, muscle, nerves, blood vessels and tendons. The team was divided into four working groups during the surgery, two focusing on each of the donor hands, and two which worked exclusively on the recipient.
According to CBS News, the doctors started by connecting the bones in his arm with steel plates and screws, then used microvascular surgical techniques to connect veins and arteries. After the reconnected blood vessels started having blood flow through them, the muscles and tendons were repaired and reattached one at a time. Finally, the nerves were reattached, the reporters said.
Doctors believe the boy’s hands will grow normally
Only 25 hand transplants have ever been done throughout the world, and Harvey is the first non-adult to undergo such a procedure. In a statement, Dr. Levin said that the “success of Penn’s first bilateral hand transplant… gave us a foundation to adapt the intricate techniques and coordinated plans required to perform this type of complex procedure on a child.”
The Baltimore Sun said that Harvey is working with occupational therapists to learn to use his new hands. His original hands and his feet were amputated after he developed gangrene due to a sepsis infection. That infection also led to a kidney transplant, and that procedure made the boy a candidate for transplant, doctors said, since he was already taking anti-rejection medication.
Harvey will remain in Philadelphia for several more weeks while he recovers, and his therapy will go on for months. For now, he is only allowed to move his hands when a therapist is present. Otherwise his hands are placed in splints so that they can remain in place and heal properly.
Dr. Levin told the newspaper that the successful procedure was “a monumental step” and that he was hopeful that his team “can help many more patients like Zion in the future.” He also told reporters that he and his colleagues “have every reason to believe that because Zion’s hands are alive and his growth plates are intact from the donor that he will grow like a normal child.”
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