UPMC Completes Nation’s Second Bilateral Hand Transplant
PITTSBURGH, Feb. 11 – A 41-year-old Harrisburg, Pa., man who lost both hands in a farming accident is the second person in the nation to receive a bilateral hand transplant and the first to have his entire forearm replaced. On Feb. 5, Chris Pollock also became the third patient treated at the University of Pittsburgh Medical Center (UPMC) with the “Pittsburgh Protocol,” an immune modulation therapy that aims to reduce the risk associated with toxic anti-rejection drugs.
“Chris is the third patient to receive a hand transplant at UPMC since March 2009. The goal of our program has always been to make hand transplants safer as a viable alternative to prosthetics. With each successful surgery, we are closer to that goal,” said members of the Composite Tissue Transplantation Program based in the Division of Plastic and Reconstructive Surgery at UPMC.
A team of surgeons, critical care specialists, transplant nurses, and therapists has cared for Mr. Pollock since the 11-hour surgery. He received a total forearm transplant, including the elbow joint, on his right side and was transplanted slightly above the wrist on his left. He will soon begin daily occupational therapy at the UPMC Institute for Rehabilitation and Research as his physicians monitor him closely for signs of rejection.
“Both of our previous hand transplant recipients have been maintained on a low-dose of a single anti-rejection drug and have regained significant function and sensation in their transplanted hands. Thus far, Chris is recovering well from surgery,” said the surgeons
Although other surgeons from around the world have performed hand transplants successfully, they have used a conventional protocol of multiple immunosuppressive medications to prevent rejection of the grafts, increasing the risk of diabetes, infections, hypertension and other disorders.
In contrast, surgeons at UPMC have implemented a two-phase protocol that involves initial antibody treatment followed by donor 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. Pollock, who lost his hands two years ago, received antibodies to help overcome the initial overwhelming immune response. That will be followed by a bone marrow infusion from the hand donor within 15 days after the surgery. Hand transplant patients are treated with tacrolimus, a drug that was first used in liver transplants by UPMC’s Thomas E. Starzl, M.D., Ph.D., more than two decades ago to prevent graft rejection.
UPMC, the U.S. Army Institute of Surgical Research and the Armed Forces Institute of Regenerative Medicine (AFIRM) are funding the hand transplant study. Surgeons performed the first unilateral hand transplant at UPMC on March 14, 2009, and the first bilateral hand transplant in the U.S. on May 4, 2009.
UPMC is an $8 billion integrated global health enterprise headquartered in Pittsburgh, Pennsylvania, and is one of the leading nonprofit health systems in the United States. As western Pennsylvania’s largest employer, with 50,000 employees, 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, Cyprus, Qatar and Japan.