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Bilateral arm transplant honed, performed on patient who lost limbs three-years ago.

Will Lautzenheiser wiggled his left forearm ever so slightly on Tuesday, demonstrating the movement for a roomful of people.

It was astonishing because both of the patient’s arms had been amputated in 2011, along with both legs, to save his life after a bacterial infection shut down his organs and killed the tissue in his limbs.

Last month, a team of 35 people, including 13 surgeons, worked for nine hours to transplant donor arms onto the patient, repairing some of the damage done three years ago. The procedure was the seventh restorative surgery at Harvard-affiliated Brigham and Women’s Hospital since it started in the field in 2009 with the country’s second partial face transplant. It was the hospital’s third bilateral arm transplant. Lessons from the others have helped surgeons to hone this complex procedure.

Will Lautzenheiser and leaders from the Brigham’s transplant program appeared at a news conference at the hospital on Tuesday to thank the anonymous donor family, and to discuss the procedure.

The patient fell ill shortly after he moved to Montana to take a new job. Doctors there found that a streptococcus infection had morphed into potentially lethal necrotizing fasciitis. Lautzenheiser was flown to Salt Lake City, where the extreme measures to save his life left him a quadruple amputee, dependent on others for nearly all his basic needs.

In June, when the Brigham and Lautzenheiser announced that he was a candidate for the transplant, Lautzenheiser cited his loss of independence as a major reason for agreeing to the risky procedure.

The recovery from such a surgery is not like flipping a switch, doctors stressed, but feeling and function should slowly increase.

Already the patient has some sensation in his new right arm near the transplant site, but it could take a year and a half for nerves to grow and for him to fully gain sensation in his limbs, state the surgical team.

Movement will return over a period of years. Physical therapy will remain a major part of Lautzenheiser’s life. Currently he spends four hours a day at the hospital, augmenting those sessions with a home regimen aided by caregivers.

Will Lautzenheiser also faces a future of taking anti-rejection drugs to keep his immune system from attacking the transplanted limbs as foreign tissue. The medical team state that there is ongoing research into ways to minimize the need for anti-rejection drugs, which can open patients to other infections and may increase cancer risk over the long term.

The new arms were secured through the New England Organ Bank who also spoke at the news conference. The donor’s family sent a brief message to Will Lautzenheiser:

“Our son gave the best hugs. We pray that you make a full recovery and that your loved ones will be able to enjoy your warm embrace.”

As for the patient’s transplant future, neither he nor his surgeons ruled out the possibility of a leg transplant, though definitely not in the near term. Leg transplantation requires a lot of arm strength during rehabilitation. And besides, Lautzenheiser said, for now he is plenty busy with the rehab required for his transplanted arms.

“This has completely transformed my life.”

Source:  The Harvard Gazette

 

Will Lautzenheiser's (center) arms were amputated in 2011 — along with both legs — in a frantic attempt to save his life after a rampaging bacterial infection shut down his organs and killed the tissue in his limbs. Last month, Lautzenheiser received a bilateral arm transplant with the help of Simon Talbot (left), director of the Brigham’s Upper Extremity Transplant Program, and Matthew Carty (right), head of the Brigham’s Lower Extremity Transplant Program.  Credit:  Kris Snibbe/Harvard Staff Photographer.
Will Lautzenheiser’s (center) arms were amputated in 2011 — along with both legs — in a frantic attempt to save his life after a rampaging bacterial infection shut down his organs and killed the tissue in his limbs. Last month, Lautzenheiser received a bilateral arm transplant with the help of Simon Talbot (left), director of the Brigham’s Upper Extremity Transplant Program, and Matthew Carty (right), head of the Brigham’s Lower Extremity Transplant Program. Credit: Kris Snibbe/Harvard Staff Photographer.

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