Nation's Fourth Hand Transplant Performed at Jewish Hospital Hand Care Center
by Kleinert Kutz and University of Louisville Surgeons
LOUISVILLE, Ky., July 12 /PRNewswire-USNewswire/ -- Dave Robert Armstrong, a
32-year-old Upland, California man has joined an elite group of men around the
world by receiving a hand transplant today, July 12, 2008. The surgery was
performed at Jewish Hospital Hand Care Center by Kleinert Kutz and University
of Louisville hand surgeons.
The 14 hour procedure, which began at approximately 2:08 a.m. (EDT) today
involved a six-member hand surgical team, with 12 hand fellows assisting and a
two-member anesthesiology team. The recipient is listed in stable condition at
Jewish Hospital. The group of surgeons performing the experimental procedure
also performed the world's first successful hand transplant in 1999, the
nation's second in 2001 and the nation's third in 2006. Kentucky Organ Donor
Affiliates coordinated the donation of the hands for all recipients.
A partnership of physicians and researchers at Jewish Hospital Hand Care
Center, Kleinert Kutz and the University of Louisville developed the
pioneering procedure. Warren C. Breidenbach, III, M.D., with Kleinert Kutz
and assistant clinical professor of surgery at the University of Louisville,
lead the surgical team. Kadiyala Ravindra, M.D., assistant professor of
surgery at University of Louisville and Joseph Buell, M.D., director, Jewish
Hospital Transplant Center, manage the immunosuppressive therapy for all the
hand transplant patients. Anesthesiology Associates and Medical Center
Anesthetists provided anesthesia services.
A hand transplant, unlike a solid organ transplant, involves multiple tissues
(skin, muscle, tendon, bone, cartilage, fat, nerves and blood vessels) and is
called composite tissue allotransplantation.
Armstrong, a manager at an automotive shop in Riverside, CA, injured his
dominant right hand six years ago when a gun misfired. Armstrong's hand was
replaced with a body operated cable prosthesis. He also uses a Myoelectric
prosthesis. He has been independent in his daily activities with the use of
the prosthesis.
Breidenbach said, "This has been the smoothest hand transplant we have
performed. We cannot control the amount of damage when an accident happens,
but in Mr. Armstrong's case we had very good muscles to work with. They were
not as badly scarred as the previous three cases."
After surgery, Armstrong was placed on a combination of immunosuppressive
drugs at a reduced dosage to lower the risks associated with the
anti-rejection medication. Those risks include a higher incidence of cancer,
infections and other disorders. Dr. Ravinda said, "Armstrong will be
monitored on a regular basis for signs of rejection with weekly biopsies,
other laboratory tests and evaluations as needed."
"What is important to note is that our last patient was the first hand
recipient in the world to receive a new drug - Campath - to avoid the use of
steroids that can cause complications," Breidenbach added. "Armstrong will
also receive Campath to avoid the use of steroids. The first two hand
patients used three immunosuppressive drugs, one of which was a steroid. One
of the first two patients suffered complications from the steroids. Now, on
Mr. Armstrong, we are attempting to achieve the same goal of avoiding
steroids. If successful, this would be the second time in the world that this
has been achieved in hand transplantation."
An orthotist and hand therapist will begin bracing and hand therapy within the
next few days. Armstrong will be hospitalized at Jewish Hospital for the next
seven to ten days and then will remain in the Louisville area for three
months.
To date, there have been a total of 39 hands transplanted on 31 patients
around the world. A total of four patients have received new hands in the
U.S., including with Armstrong--Matthew Scott in 1999, Jerry Fisher in 2001
and David Savage in 2006--by the same Kleinert Kutz team of surgeons at Jewish
Hospital Hand Care Center.
Information, photography and video are available on our web sites at
http://www.handtransplant.com and http://www.jewishhospital.org.
SOURCE Jewish Hospital Hand Care Center
Barbara Mackovic, of Jewish Hospital, +1-502-587-4230, Mobile +1-502-641-5461
