For the first time in history, doctors were finally able to do a transplant of both hands and forearms to a child. The patient is an 8-year old boy named Zion Harvey. He lost his hands and feet when he was 2, due to an infection that also led to a kidney transplant.
The surgery took place at the Children’s Hospital of Philadelphia. It was a 10-hour procedure and involved 40 members to perform it. The team included nurses, doctors and surgeons under the lead of Dr. L. Scott Levin, chairman of the department of orthopedic surgery at Penn Medicine and director of the “hand transplantation program” at CHOP.
During the operation the hands and forearms were delicately connected by attaching bone, blood vessels, nerves, tendons and skin. Dr. Levin divided the team into four groups: two would focus on the donor hands, and the other two would work on the recipient. First, the bone was connected to the arm with steel plates and screws. Then, the doctors connected the arteries and veins. Once there was a normal blood flow through the reconnected arm, surgeons rejoined each muscle and tendon one-by-one. Finally, they attached nerves and closed the open wounds.
“The success of Penn’s first bilateral hand transplant on an adult, performed in 2011, gave us a foundation to adapt the intricate techniques and coordinated plans required to perform this type of complex procedure on a child,” Levin said. “CHOP is one of the few places in the world that offer the capabilities necessary to push the limits of medicine to give a child a drastically improved quality of life.”
Until now, just 25 full hand transplants have been done globally. Zion is the first child patient who has ever received one.
Of course, double hand transplant is still a very uncommon procedure. It is very complex and not everyone could be a potential recipient. Zion was an ideal transplant candidate due to his previous kidney transplant.
“Zion’s kidney transplant following his infection made him a candidate for transplant because he was already taking anti-rejection medication,” Dr. Benjamin Chang, co-director of CHOP’s Hand Transplant Program and associate chief of the Division of Plastic Surgery at Penn Medicine, said.
Harvey has still many years ahead to keep growing up. Doctors said his new arms will grow along with him just fine.
“Once we reattached the parts, the growth plates stay open and allow the amputated part to grow, so we 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.”, Dr. Levin explained.