
Surgeons at The Children's Hospital of Philadelphia (CHOP), joined by colleagues from Penn Medicine, recently completed the world's first bilateral hand transplant on a child. Earlier this month, the surgical team successfully transplanted donor hands and forearms onto eight-year-old Zion Harvey.
Dr. L. Scott Levin, Director of the Hand Transplantation Program at The Children's Hospital of Philadelphia, led a multidisciplinary team of 40 medical practitioners to complete to surgery. Dr. Levin said at a press conference earlier this month that the success of the operation was a major breakthrough in the field of restorative surgery.
"I'm going to share with our audience this afternoon a huge step forward in transplantation, the world of transplantation in pediatric surgery, in this relatively new field called vascularized composite allo transplant, which is the transplant of hands and in other cases faces. And it's a huge step forward in the movement of reconstructive surgery and now what we call restorative surgery. "
The recipient of the transplant, Zion Harvey, is an eight year old from Baltimore, Maryland. At the age of two, Zion underwent amputation of his hands and feet and a kidney transplant following a serious infection.
Zion is a bright and precocious eight-year-old who has said he cannot wait to someday throw a football. A happy and outgoing child, he has adapted well to life without hands, learning to eat, write and even play video games. He says he'd be ok even if the surgery did not go well.
"It wouldn't matter to me because I have supporting family, supporting cousins, supporting grandparents. So if it didn't go well I would have my family to go back on."
Although the surgery was successful, Zion does not have use of his hands yet since it could take up to eight months for the nerves in his fingers to regenerate. Zion has prosthetics for his feet and can walk, run and jump with complete independence.
Doctors said Zion's successful kidney transplant previously helped with his hand transplantation because he was already taking medication to stop his body from rejecting his kidney.
The world's first hand transplant was performed in France in 1998. Multiple limb transplants on adults have been successfully done before, but a child's smaller blood vessels, tissue and nerves present more challenges.
Dr. Benjamin Chang, the co-director the Hand Transplant Program at The Children's Hospital of Philadelphia, said the surgery was enormously complex and required close coordination from multiple teams.
"In the beginning of the operation we actually had four teams operating at the same time. And each of them had specific things they were supposed to do. So they had to find all the structures, put pre-made tags on them for every single structure that we'd have to repair and they would have to sew those on to the nerves, blood vessels, tendons etcetera. "
Only a small number of potential donors are available every year, but Zion's doctors were able to find a suitable donor very quickly.
Doctors caution that Zion is only at the beginning of his journey. He currently has physical therapy daily and will have to rely on immuno-suppressant medication for life to stop his body from rejecting the new hands.
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