Former Marine is First to Receive Hand Transplant at UPMC
Study of New Immune Modulation Protocol Aims to Lower Use of Anti-Rejection Drugs
PITTSBURGH, April 2, 2009 — The University of Pittsburgh Medical Center (UPMC) announced today that it performed its first, and the nation’s sixth, hand transplant on March 14. Former Marine Josh Maloney, 24, who lost his right hand in a military training accident, is the first patient to be treated with the “Pittsburgh Protocol,” a new immune modulation therapy that aims to reduce the risk associated with toxic anti-rejection drugs.
“This ground-breaking surgery at UPMC represents the culmination of more than 20 years of research in the field of hand transplantation,” said W.P. Andrew Lee, M.D., chief of the Division of Plastic and Reconstructive Surgery and leader of the hand transplant surgical team. “Thus far, Josh is meeting our expectations for recovery. He is already making steady progress in hand therapy, and we expect him to regain significant movement and sensation in the transplanted hand in the next six to 12 months as he works with his team of occupational therapists.”
A multidisciplinary hand transplant team composed of surgeons, hematologists, nurses, therapists and researchers has cared for Mr. Maloney, of Bethel Park, Pa. since the 11-hour surgery. He will receive daily occupational therapy at UPMC in the coming months as his physicians monitor him closely for signs of rejection.
Although surgeons from around the world have performed hand transplants successfully, they have used a traditional protocol of multiple immunosuppressive medications to prevent rejection of the grafts, increasing the risk of diabetes, infections and other disorders.
In contrast, surgeons at UPMC have implemented a two-phase protocol that involves initial antibody treatment followed by bone marrow cell therapy. The goal is not merely to suppress the immune system but to change the way it functions. Under the protocol, Mr. Maloney received antibodies to help overcome the initial overwhelming immune response. That was followed by a bone marrow infusion from the hand donor 15 days after the surgery. Patients are treated with tacrolimus, a drug that was first used in liver transplants by Thomas E. Starzl, M.D., Ph.D., more than two decades ago to maintain the low-grade immunosuppression needed to prevent long-term graft rejection.
“Unlike a solid-organ transplant, which is needed to sustain or prolong life, a hand transplant enhances the quality of life,” said Dr. Lee. “We have devoted many years of research to developing an immunomodulatory protocol that will reduce the risks of the procedure for the long-term health of our patients. This would allow more amputees to be considered for hand transplants in the future. Currently, we have three people approved for hand transplant awaiting suitable donors.”
Funding for the hand transplant study is supplied through UPMC and the Armed Forces Institute of Regenerative Medicine (AFIRM), a joint initiative of the U.S. Army Medical Research and Materiel Command, Institute of Surgical Research, the Office of Naval Research, the U.S. Air Force, the National Institutes of Health and the Department of Veterans Affairs.
UPMC is an integrated global health enterprise headquartered in Pittsburgh, Pennsylvania, and one of the leading nonprofit health systems in the United States. As western Pennsylvania’s largest employer, with 50,000 employees and $7 billion in revenue, UPMC is transforming the economy of the region into one based on medicine, research and technology. By integrating 20 hospitals, 400 doctors’ offices and outpatient sites, long-term care facilities and a major health insurance services division, and in collaboration with its academic partner, the University of Pittsburgh Schools of the Health Sciences, UPMC has advanced the quality and efficiency of health care and developed internationally renowned programs in transplantation, cancer, neurosurgery, psychiatry, orthopaedics and sports medicine, among others. UPMC is commercializing its medical and technological expertise by nurturing new companies, developing strategic business relationships with some of the world’s leading multinational corporations and expanding into international markets, including Italy, Ireland, the United Kingdom, Qatar and Cyprus. For more information about UPMC, visit our website at www.upmc.com.