On February 5, McGowan Institute for Regenerative Medicine
faculty member W. P. Andrew Lee, M.D., chief of the Division of Plastic and Reconstructive Surgery at UPMC and leader of the hand transplant surgical team, treated Chris Pollock 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—a 41-year-old Harrisburg, Pennsylvania, 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.
“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 Dr. Lee.
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 Dr. Lee.
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, Dr. Lee and 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 2 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 2 decades ago to prevent graft rejection.
“Unlike a solid-organ transplant, which is needed to prolong life, a hand transplant improves only the quality of life,” said Dr. Lee. “We take very seriously the long-term health of our patients. We have devoted many years of research to developing an immunomodulatory protocol that will reduce the risks of the procedure. We believe our new protocol will achieve this goal, allowing more amputees to be considered for hand transplants in the future.”
UPMC, the U.S. Army Institute of Surgical Research, and the Armed Forces Institute of Regenerative Medicine (AFIRM) are funding the hand transplant study. Dr. Lee and 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 Media Relations (02/11/10)
Pittsburgh Post-Gazette (02/11/10)
Lebanon Daily News (02/11/10)
Fox News (02/12/10)
Pittsburgh Post-Gazette (02/12/10)
Pittsburgh Tribune-Review (02/12/10)
McGowan Institute for Regenerative Medicine In the News: Successful Hand Transplants Performed
UPMC: Hand Transplant
Bio: Dr. W. P. Andrew Lee