A medical team at Brigham and Women's Hospital in Boston announced today they will attempt a double-arm transplant on a Texas woman, the first such transplant in the country.
Katy Hayes, a 43-year-old Kingwood, Texas, mother of three, was added to the transplant list after completing a range of physical and psychological tests to determine her suitability for the still-experimental procedure. After the birth of her third child in 2010, Hayes developed the flesh-eating bacteria infection known as group A streptococcus. Doctors were forced to amputate her arms just below the shoulders in order to save her life.
In a video released by Brigham and Women's Hospital, Hayes talked about the shock of emerging from a weeks-long coma to learn she had lost her arms. "All of my innards had been cut out and my limbs were gone...It was more than I could grasp."
But, she added, "I have a good life and determination to be normal again."
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Surgeons are attempting more complex procedures, such as transplanting faces and limbs. While the surgeries are more involved, techniques are also improving, allowing people who have suffered catastrophic injuries to do what most of us take for granted—get dressed, type, pick up a baby.
Hand and arm transplants are still relatively uncommon in the United States. The first hand transplant, a surgery attaching a donor hand just above the wrist, was performed in France in 1998. Since then, there have been 38 hand transplants worldwide, including several double-hand transplants.
Far fewer people have undergone transplants of arms—attaching a donor arm above the elbow. The world's first double-arm transplant was performed in 2008 in Germany. Earlier this year a man in Mexico City had a double hand transplant after his arms were severely burned and then amputated just below the elbow.
In best-case scenarios, hand and arm transplants can return a high level of function to patients, according to experts from Brigham and Women's Hospital. Recipients need to take anti-rejection medications their entire lives, and the first year following the surgery requires patience to allow the slow-growing nerves in the patient's arm and the donor arm to connect. Patients must adhere to rigorous physical therapy to learn how to use the new limbs.
According to studies, 94 percent of hand recipients gain sensation and most have enough muscle recovery to perform daily activities, such as getting dressed, cooking, and driving.
Last year, Brigham and Women’s Hospital doctors performed a double-hand transplant on a 65-year-old man. The 12-hour procedure involved reconnecting skin, tendons, muscles, ligaments, bones and blood vessels.
The first hurdle for Hayes and her doctors, however, will be to identify a donor. The hospital is working with the New England Organ Bank to search for suitable donor limbs. Besides finding a donor with compatible blood and tissue types, doctors will also look for limbs that will closely match the recipient in terms of size and skin tone. A near-perfect aesthetic match is critical to helping the patient adjust psychologically, doctors say.
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A donor's family will be asked to consent to the surgery. According to the website Donate Life, the number of registered eye, tissue, and organ donors continues to rise in the United States. But more than 100,000 Americans are awaiting transplants.
Hayes and her husband, Al, say they are trying to stay positive while they await a call from the hospital that donor limbs have been identified.
"If I thought I could never hold (Al) again or hold the baby, I think I would be very depressed," Katy Hayes said. "This has given me hope to keep fighting on."
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Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.