PITTSBURGH – A 33-year-old woman from New Jersey on September 18 became the first female in the United States to receive a bilateral hand transplant. After a 12-hour surgery, Sheila Advento, whose hands were amputated after an infection seven years ago, became the fifth patient at UPMC to receive a hand transplant under the “Pittsburgh Protocol,” an immune modulation therapy that aims to reduce the risks associated with toxic anti-rejection drugs.
A team of surgeons, critical care specialists, transplant nurses and therapists has cared for Ms. Advento since the surgery, and she will soon begin daily occupational therapy at the UPMC Rehabilitation Institute as her physicians monitor her closely for signs of rejection.
Surgeons performed the first unilateral hand transplant at UPMC on March 14, 2009, the first bilateral hand transplant in the U.S. on May 4, 2009, and their second bilateral and first above elbow transplant on February 5, 2010. Most recently, they successfully transplanted a single hand on their first female patient on Sept. 11, 2010.
“All of our previous hand transplant recipients have been maintained on a low-dose of a single anti-rejection drug and have regained significant function and sensation in their transplanted hands,” said W.P. Andrew Lee, M.D., chief of the Division of Plastic and Reconstructive Surgery at UPMC and leader of the hand transplant surgical team.
Surgeons at UPMC have implemented a two-phase protocol that involves initial antibody treatment followed by donor bone marrow cell therapy. The goal is not merely to suppress the immune system, but to change the way it functions. Under the protocol, Ms. Advento received antibodies to help overcome the initial overwhelming immune response. That will be followed by a bone marrow infusion from the hand donor within 15 days after the surgery. Hand transplant patients are treated with tacrolimus, a drug that was first used in liver transplants by the University of Pittsburgh’s Thomas E. Starzl, M.D., Ph.D., more than two decades ago to prevent graft rejection.
UPMC, the U.S. Army Institute of Surgical Research and the Armed Forces Institute of Regenerative Medicine (AFIRM) are funding the hand transplant study.
UPMC is an $8 billion integrated global health enterprise headquartered in Pittsburgh, Pennsylvania, and is one of the leading nonprofit health systems in the United States. As western Pennsylvania‘s largest employer, with almost 50,000 employees, UPMC is transforming the economy of the region into one based on medicine, research, and technology. By integrating 20 hospitals, 400 doctors’ offices and outpatient sites, long-term care facilities, and a major health insurance services division, and in collaboration with its academic partner, the University of Pittsburgh Schools of the Health Sciences, UPMC has advanced the quality and efficiency of health care and developed internationally renowned programs in transplantation, cancer, neurosurgery, psychiatry, orthopaedics, and sports medicine, among others. UPMC is commercializing its medical and technological expertise by nurturing new companies, developing strategic business relationships with some of the world‘s leading multinational corporations, and expanding into international markets, including Italy, Ireland, the United Kingdom, and Japan. For more information about UPMC, visit our website at www.UPMC.com