Louisville Team Performs Transplant on Bowling Green, Kentucky Man - Archived

Louisville team performs hand transplant on Bowling Green, Kentucky man

clinical trial. He led a team of 26 hand surgeons to perform the procedure. Michael Marvin, MD, director of transplantation at Jewish Hospital and associate professor of surgery at the University of Louisville, is also a co-principal investigator.

The 67-year-old hand transplant recipient injured both hands in an accident when he lost control of his car during a test drive at a race track on July 20, 2012. His right hand was amputated and left hand was de-gloved at the wrist during the accident. Kleinert Kutz hand surgeons were able to save his left hand, but not the right. 

Mr. Ray used a hook-type prosthesis for his right hand and needed help with many of the activities of daily living. He is right hand dominant.

“This is the first patient where our team has had to do an amputation, said Tuna Ozyurekoglu, MD, hand surgeon with Kleinert Kutz “This makes it so special for us, and such a rewarding moment, because we are able to give him a new hand,” he said.

“Mr. Ray’s pain level is very controlled,” Dr. Ozyurekoglu continued. “He is doing great, looks great and is very motivated for his upcoming therapy. This amputation was close to the elbow, so we will rely on nerve regeneration more on this patient than in previous cases. We’re hopeful that the use of these stem cells will help speed up the nerve regeneration. We are hopeful that he will have a fully functional hand,” he said.

“Without the donor and donor family, we wouldn't be able to do any of this,” said Dr. Marvin. “This is the first national share for vascularized composite allotransplantation, and it shows how transplant organizations across the country are dedicated to the work we’re doing with the Louisville VCA team.

We haven't seen any complications at this point with Mr. Ray’s transplant and we are continuing to monitor his immunosuppression (anti-rejection drug) therapy,” added Dr. Marvin. 

The patient’s immune system will be suppressed with a combination of drugs. A team of physicians from Jewish Hospital, University of Louisville and Kleinert Kutz will closely monitor the patient for signs of rejection and adverse reaction to medications with lab tests and biopsies. 

In addition, a new study will test whether cells isolated from Mr. Ray’s own fat tissue will modulate his immune system and reduce the amount of drugs needed to prevent rejection.  In a collaboration with the Louisville VCA Program, Stuart K. Williams, PhD, director, Bioficial Organs Program, and James B. Hoying, PhD, chief, division of Cardiovascular Therapeutics, both with the Cardiovascular Innovation Institute, stromal vascular fraction (SVF) cells will be isolated from the patient’s fat and injected into the new hand.  The patient will receive the same care as any other hand transplant recipient, and his progress will be monitored to see if the amount or severity of rejection is reduced by the SVF cell treatment.

“With this research model, the patient’s own fat cells are removed from the body and then immediately processed and injected into the hand. It is our hope and desire that this study will improve tissue response, dramatically impact healing and reduce need for immunosuppression in patients like Mr. Ray,” said Dr. Williams. 

The Louisville VCA team was awarded $850,000 to fund the clinical trial for the new treatment that will help prevent rejection in hand transplantation. The funding comes as part of the Armed Forces Institute of Regenerative Medicine (AFIRM) research program. AFIRM II is a five-year, $75 million Department of Defense funded project that will focus on applying regenerative medicine to battlefield injuries.

“There are 13 groups working on vascularized composite allotransplant models throughout the country as part of AFIRM II and the Louisville VCA is the first to bring our research to a patient,” said Christina Kaufman, PhD, executive director, Christine M. Kleinert Institute for Hand & Microsurgery.  “We’re hoping that nerve regeneration in this patient will be quicker with the addition of these cells. Today is a terrific day.” 

Results of this trial will be far-reaching and benefit not only military patients, but all hand transplant recipients.

The Louisville team developed the pioneering hand transplant procedure and has performed hand transplants on nine patients since 1999. The clinical trial is led by primary investigator Joseph Kutz, MD, with research at the CMKI and the Cardiovascular Innovation Institute, a partnership of Jewish Hospital and the University of Louisville.

Funding for the surgical procedure was provided by the Jewish Hospital & St. Mary’s Foundation, part of KentuckyOne Health.

The Kentucky Organ Donor Affiliates arranged the hand donation for the team’s hand transplant procedure.

Patient and physician information are available at www.handtransplant.com and http://youtu.be/6nxkH7srEvE.

Cutline:
Kleinert Kutz surgeon, Tuna Ozyurekoglu, MD, and Christine M. Kleinert Institute fellows Benjamin Wei, MD, and Colleen Calvey, MD, identify structures and prepare for bone work while Joseph E. Kutz, MD, oversees the operation.

About Jewish Hospital
Jewish Hospital, a part of KentuckyOne Health, is an internationally renowned high-tech tertiary referral center developing leading-edge advancements in hand and microsurgery, heart and lung care, home care, rehab medicine (including sports medicine), orthopedics, neuroscience, occupational health, organ transplantation and outpatient and primary care.  Site of the world’s first successful hand transplant, the world’s first and second successful AbioCor® Implantable Replacement Heart procedures, and world’s first trial of cardiac stem cells in chronic heart failure, the hospital is in the select group that performs heart, lung, liver, kidney and pancreas transplantation.

About the Christine M. Kleinert Institute for Hand and Micro Surgery

Named in honor of Dr. Kleinert's mother, the Christine M. Kleinert Institute for Hand and Micro Surgery (CMKI) is a world-renowned nonprofit education and research organization.  The physicians of the Kleinert Kutz Hand Care Center teach the next generation of hand surgeons through CMKI’s accredited fellowship program, which is a cooperative effort with the University of Louisville School of Medicine. The Fellows are fully trained plastic, orthopedic, or general surgeons from around the world who come to Louisville to get additional training in hand and micro surgery. To date, more than 1,274 physicians from 61 countries have served as Fellows. Dozens of research projects refining surgical techniques, testing new devices, and pushing the frontiers of basic and clinical science in the field of hand surgery are currently underway. CMKI also provides patient rehabilitation through the Hand Therapy Center and Orthotic Care Center. For more information, please visit www.cmki.org or call 502.562.0310.

About the Kleinert Kutz Hand Care Center

Kleinert Kutz is one of the largest hand care programs in the world, pioneering achievements in hand and microsurgery, research, therapy and orthotics. The 13 physicians of Kleinert Kutz offer expertise in orthopedic and plastic surgery and provide comprehensive care for the hand and arm. Kleinert Kutz’s significant achievements include the nation’s first five hand transplants, one of the world’s first cross-hand replantations, pioneered work in primary reconstruction using free tissue transfer and national award for research in blood flow to the nerve.  For more information, please visit www.kleinertkutz.com or call 502.561.4263.

About the University of Louisville
The University of Louisville is Kentucky's metropolitan research university, with 22,000 students attending classes at 11 colleges and schools on three campuses. Bordered by its many medical partners, UofL's downtown Health Sciences Center is home to more than 3,000 students pursuing degrees in health-related fields with the Schools of Dentistry, Medicine, Nursing and Public Health and Information Sciences, as well as 14 interdisciplinary centers and institutes.

About the Cardiovascular Innovation Institute

Since opening its doors in 2007, the Cardiovascular Innovation Institute (CII), a joint initiative between the University of Louisville and Jewish Hospital has focused on the discovery, research, development and implementation of innovative treatments for cardiovascular disease. Our main goal is to foster a world-class collaborative, integrated, multi-disciplinary enterprise encompassing basic, translational, clinical, and population research in cardiovascular disease, affecting individuals throughout their entire lifespan, from pre-natal life to death. This is also the goal of the National Institutes of Health and has been identified as the most important area of medical research for the next decade.

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