UPMC transplant team attaches right arm, left hand

A little more than a year ago, farmer Chris Pollock got his right arm caught in a corn picker near Harrisburg.

When he tried to get it out with his left hand, it got mangled, too.

On Friday, Mr. Pollock became America's second double-hand transplant recipient, with both operations having taken place at UPMC under the leadership of plastic surgeon W.P. Andrew Lee.

Using limbs donated by a West Virginia man, a 21-member surgical team spent 11 hours attaching one arm above Mr. Pollock's right elbow, and transplanting a left hand just above his wrist.

After his horrific accident, his right arm had been amputated just below the elbow by Dr. Shane Johnson of Penn State Hershey medical center, who had once trained with Dr. Lee at Massachusetts General Hospital.

But when Mr. Pollock was evaluated for a transplant last year, Dr. Lee told him that the bones, skin and other tissue below his elbow were too badly damaged to attach to a transplanted limb.

Doctors would have to amputate again and attach the limb on his upper right arm, using the donor's elbow, Dr. Lee told him, and then gave him time to think it over. The next day, Mr. Pollock said he'd like to go ahead.

Mr. Pollock was in the intensive care unit Thursday, but was doing well and may be released to a regular room soon, Dr. Lee said.

The surgery was one of the few above-the-elbow limb transplants done in the world.

Like UPMC's two previous operations -- a double hand-arm transplant done last May on Air Force veteran Jeff Kepner of Augusta, Ga., and a right hand transplant in March on Marine veteran Joshua Maloney of Bethel Park -- doctors are using a medication regimen called the "Pittsburgh Protocol" on Mr. Pollock.

It consisted of a strong dose of immune-dampening medication at the time of surgery, to keep his body from rejecting the new limbs, and will include an infusion of bone marrow from the donor next week to help coax his body into accepting the transplanted tissue.

Mr. Kepner, who lost his hands and feet to a severe bacterial infection a decade ago, was back at UPMC last week after experiencing a minor rejection episode.

One good thing about hand transplants is that rejection shows up quickly as a skin rash and can be treated with topical anti-rejection creams, which worked in Mr. Kepner's case, Dr. Lee said.

Mr. Maloney has made remarkable progress, Dr. Lee added, and is now playing Sony PlayStation video games with his transplanted hand. "I've now concluded this is a wonderful therapy," Dr. Lee said.

The nerves from Mr. Maloney's arm have now grown into his new hand enough that he has "two-point discrimination," the surgeon said, meaning he can sense objects with two different digits at once.

Asked how he felt after his third successful hand transplant, Dr. Lee said "I'm again very proud of how a large team of plastic surgeons, transplant surgeons and orthopedic surgeons worked together so well to achieve this bilateral hand transplant."