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Risks of Immunosuppression After Upper Extremity Transplantation Minimized by Novel Cellular-Based Therapy
A 24-year-old former Marine who received a wrist-level hand transplant in March 2009 is back at work as an electrician. "He has shown remarkable progress with func-tion and an encouraging return of quality of life. He has had only a few episodes of rejection that were completely resolved with topical immunosuppressant creams alone without additional treatment," according to Vijay Gorantla, MD, PhD, assistant professor in the department of surgery, University of Pittsburgh, and director of the Composite Tissue Allotransplantation Program at the University of Pittsburgh Medical Center. Two other patients have achieved similar levels of functionality and success. One is a 57-year-old Air Force Veteran who was the first person in the U.S. to have both hands transplanted in May 2009. The other is a 41-year-old mechanic who is the first patient in the U.S. to receive a combined bilateral hand and full above-the-elbow forearm transplant in February 2010.
These three patients are the first in the world to have a novel cell-based treatment for modulating the immune system after upper extremity transplantation. The therapy known as "The Pittsburgh Protocol" is unique in utilizing bone marrow cells to enable reduction of the need for multiple anti-rejection drugs after transplantation. The University of Pittsburgh Medical Center is currently the only transplantation center in the world to offer it. An early report of the initial experience with the "Pittsburgh Protocol" in three recipients of upper extremity transplants was presented during the 2010 Annual Clinical Congress of the American College of Surgeons.
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