Wounded soldier gets double-arm transplant in Md.

AP News
Posted: Jan 28, 2013 11:10 AM

BALTIMORE (AP) — A soldier who lost all four limbs in a roadside bomb attack in 2009 in Iraq has received a double-arm transplant in Baltimore, Johns Hopkins Hospital officials said Monday.

Surgeons who treated the unidentified infantryman plan to discuss the transplant Tuesday at a news conference with the soldier. The soldier is one of seven in the U.S. who have undergone successful double-arm transplants, the hospital said.

The transplant last month is the first for the hospital and involved an innovative treatment to prevent rejection of the new limbs. The treatment used the dead donor's bone marrow cells and so far has prevented rejection and reduced the need for anti-rejection drugs. Those drugs can cause complications, including infection and organ damage, hospital officials said.

The novel treatment to help prevent rejection was pioneered by Dr. W.P. Andrew Lee, plastic surgery chief at Johns Hopkins, when he previously worked at the University of Pittsburgh.

In his previous job, Lee led five single-hand transplant operations on five patients, giving them new hands plus marrow from their donors. In an interview last fall, Lee said that all five recipients had done well and that four were taking only one anti-rejection drug instead of combination treatments most transplant patients receive.

Minimizing anti-rejection drugs is important because they have side effects and raise the risk of cancer over the long term. Those risks have limited the willingness of surgeons and patients to do more hand, arm and even face transplants. Unlike a life-saving heart or liver transplant, limb transplants are aimed at improving quality of life, not extending it.

Quality of life is a key concern for people missing arms and hands — prosthetics for those limbs are not as advanced as those for feet and legs.

Lee has received funding for his work from AFIRM, the Armed Forces Institute of Regenerative Medicine, a cooperative research network of top hospitals and universities around the country that the government formed about five years ago. With government money, he and several other plastic surgeons around the country are preparing to do more face transplants, possibly using the new minimal immune suppression approach.