THE WORLD’S FIRST double hand transplant in a child has been successful.
Zion Harvey underwent the double hand transplant 18 months ago at the Children’s Hospital of Philadelphia, US, when he was eight years old.
The past year-and-a-half been a long journey for Harvey as he has faced a number of setbacks.
His body rejected his new hands a number of times and he had to undergo extensive rehabilitation to help him learn to use them.
Despite this, Harvey is now able to write, and feed and dress himself independently, according to the first medical report of the surgery, published in the Lancet Child & Adolescent Health journal.
Dr Sandra Amaral of the Children’s Hospital of Philadelphia said:
“Eighteen months after the surgery, the child is more independent and able to complete day-to-day activities.
He continues to improve as he undergoes daily therapy to increase his hand function, and psychosocial support to help deal with the ongoing demands of the surgery.
His journey
Harvey was chosen for the surgery because he was already receiving immunosuppression for a kidney transplant, which he needed following a sepsis infection. (Immunosuppression is a treatment to stop the body rejecting an organ following transplantation.) The infection previously led to the amputation of his hands and feet when he was two years old.
Before his double hand transplant, Harvey faced constant daily struggles.
Harvey struggled to dress himself, feed himself and wash himself.
His mother hoped that a successful surgery would leave him able to dress himself, brush his own teeth and cut food independently, according to the study.
“The boy wanted to be able to climb monkey bars and grip a baseball,” the researchers said.
Harvey and his family waited until suitable donor hands became available.
This day came in July 2015 and four medical teams worked together to transplant the donor hands to Harvey.
It took the team of 40 doctors, nurses and other staff 10 hours to carry out the complex surgery.
He began occupational therapy almost immediately, including playing video games and exercises using puppets. Within days, Harvey was able to move his fingers.
After six months, Harvey was able to feel touch – which meant he became able to feed himself and hold a pen.
By eight months, he was able to use scissors and crayons. Within a year of the surgery, he could swing a baseball bat using both hands.
Challenges
Although Harvey was making speedy progress in his rehabilitation programme, he has faced eight instances of his system rejecting the new hands since the surgery.
Harvey suffered two serious episodes during the fourth and seventh months following his transplant. Along with this, he also faced some minor infections. These were all reversed with immunosuppression drugs without impacting the long-term function of his new hands.
“While functional outcomes are positive and the boy is benefitting from his transplant, this surgery has been very demanding for this child and his family,” Dr Amaral said.
The researchers stressed that caution should be taken when assessing the benefits and risks of future hand transplants.
They said that more data needs to be collected to help improve this type of surgery in children, and that a long-term follow-up will be needed to help others who may undergo the surgery in the future.
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