Wednesday, December 1, 2010

Rejection

Doctor Richard Edwards, a chiropractor from Oklahoma and the nation's third double hand transplant, was recently in the news again.  This time it a report that he “may lose the fingertips on his right thumb and pinkie because his body started to reject the new limbs.”

Dr. Edwards’ surgery was live tweeted when it was done in August by Louisville surgeons at The Jewish Hospital Hand Care Center.

Jeff Kepner, the first patient in the United States to receive two hands simultaneously, experienced an episode of rejection which was dealt with successfully.

Rejection is never a good thing in a transplant patient not matter which organ or part transplant.  Even though I applaud the advances being made, we must always consider the cost of the proposed treatment and ask if there a better option for this individual?

Hand or arm transplantation is not possible for all.  A missing arm can bring (social) rejection to the individual as it did for this woman, Tammy Chinander (photo credit, shown with her daughter Krystal).  [H/T from @vpmedical]

The Rudd native lost her arm at the age of 2 when she caught it in a wringer washing machine. The arm was amputated above the elbow.

For years, she managed with an arm with a hook, but at the age of 31, she decided she was through with it.

"I got tired of it hanging there," she said. "It wasn't working. It looked bad. My son was scared of it."

The best choice for her turned out to be a German-manufactured Otto Bock DynamicArm, typically $75,000 to $100,000 in cost which will be paid by her insurance.

Chinander's goal is to get the new arm to work as well as her other arm. Right now, it takes serious concentration to use it.

"I'm going through the second part of my life learning to do everything two-handed," she joked.

…..Krystal could not hold back the tears as she described what it is like for them.

"Getting that first two-armed hug from your mom that you see all the other kids getting is really wonderful," she said.

 

 

REFERENCES

Hand Transplant Fact Sheet: History and Evolution of Hand Transplantation;  UPMC/University of Pittsburgh Schools of the Health Sciences 

Transplantation — A Medical Miracle of the 20th Century; Peter J. Morris, F.R.S.; N Engl J Med 2004; 351:2678-2680December 23, 2004

Immunosuppression and Rejection in Human Hand Transplantation; Schneeberger S, Gorantla VS, Hautz T, Pulikkottil B, Margreiter R, Lee WP;  Transplant Proc. 2009 Mar;41(2):472-5.

1 comment:

Margaret Polaneczky, MD (aka TBTAM) said...

Wow that is a great looking arm she has there!

Nice post, thanks