Jeff Kepner, the nation’s first bilateral hand transplant recipient, is speaking publicly about his surgery and the progress he has made since the May 4 procedure, according to a statement released by UPMC, Pittsburg. Kepner lost both hands and feet following a bacterial infection in 1999, and is the second patient to be treated with the “Pittsburgh Protocol,” a new immune modulation therapy that aims to reduce the risk associated with toxic antirejection drugs, says the statement.
A transplant team composed of surgeons, hematologists, nurses, therapists, and researchers has cared for Kepner since the 9-hour surgery. He receives daily occupational therapy at UPMC as his physicians monitor him closely for signs of rejection, says the statement.
Although surgeons from around the world have performed hand transplants successfully, they have used a traditional protocol of multiple immunosuppressive medications to prevent rejection of the grafts, increasing the risk of diabetes, infections, hypertension, and other disorders, according to the statement.
In contrast, surgeons at UPMC have implemented a two-phase protocol that involves initial antibody treatment followed by bone marrow cell therapy, says the statement. The goal is to suppress the immune system and to change the way it functions. Under the protocol, Kepner received antibodies to help overcome the initial overwhelming immune response, followed by a bone marrow infusion from the hand donor 15 days after the surgery. Patients are treated with tacrolimus, a drug that was first used in liver transplants by UPMC’s Thomas E. Starzl, MD, PhD, more than 20 years ago to maintain the low-grade immunosuppression needed to prevent long-term graft rejection, says the statement.
W.P. Andrew Lee, MD, chief of the Division of Plastic and Reconstructive Surgery and leader of the UPMC hand transplant surgical team said in the statement that, unlike a solid-organ transplant, which is needed to sustain or prolong life, a hand transplant enhances the quality of life. The researchers have devoted many years of research to developing an immunomodulatory protocol that may reduce the risks of the procedure for the long-term health of patients, which would allow more amputees to be considered for hand transplants in the future, he added. He says three people have been approved for hand transplants pending suitable donors.
UPMC and the Armed Forces Institute of Regenerative Medicine are funding the hand transplant study. Surgeons performed the first unilateral hand transplant at UPMC on March 14, says the statement.
Click here for more information on the hand transplant program, including photos and video of Kepner’s surgery and hand therapy.
UPMC is an $8 billion integrated global health enterprise, and one of the leading nonprofit health systems in the United States, says the statement.