The surgeons are hopeful that Zion will go on to enjoy a normal life after his successful surgery.
Image credit: CHOP
"This surgery was the result of years of training, followed by months of planning and preparation by a remarkable team," remarks Dr. Scott Levin, director of the Hand Transplantation Program at the Children's Hospital of Philadelphia (CHOP).
In 2011, the Penn team conducted their first bilateral hand transplant on an adult, and according to Dr. Levin, this experience gave the surgeons a foundation from which to plan to perform such a complex procedure on a child.
The patient receiving the transplantation was 8-year-old Zion Harvey, a young boy who had received a kidney transplant and had both his hands and feet amputated several years previously after suffering a serious infection.
Initially, Zion was seen at Shriners Hospitals for Children in Philadelphia, a facility known for its pediatric orthopedic care. However, he was eventually identified as a patient who might be suitable for the first ever pediatric hand transplant.
"The collaborative effort between these institutions was necessary to assemble the team and organize the players to orchestrate such a complex and demanding procedure that had never been performed on a child," explains Dr. Scott H. Kozin, chief of staff for Shriners Hospitals for Children and surgical collaborator.
Comprehensive assessments must be conducted before a patient can be confirmed to receive a bilateral hand transplant. It was his earlier kidney transplant that made Zion a possible candidate for the surgery as this meant that he was already taking immunosuppressant medication to prevent the rejection of his transplanted organ.
A total of 40 staff participated in the 10-hour operation
For the operation, four teams of surgeons - two for the donor hands and two for the recipient's limbs - worked to attach the hands to the patient's forearms, first connecting the bones before moving onto the blood vessels, muscles, tendons, nerves and then skin.
Post-surgery, Zion continues to receive his immunosuppressant medication while being cared for by both a kidney transplant team and his hand transplant surgical team. After a week in the pediatric intensive care unit, he eventually moved to an inpatient rehabilitation unit where he continues to receive frequent and rigorous hand therapy.
He was able to adapt well to life without hands, and with prosthetic feet he has been able to walk, run and jump with complete independence. Zion told his doctors that he wants to throw a football someday, and his carers fully believe that he will be able to do this once he has completed several more weeks in the rehabilitation unit.
"We have learned the importance of closely monitoring and managing the activity of the immune system through years of experience, and are hopeful that Zion will enjoy excellent long-term allograft function and a normal life," says Dr. Abraham Shaked, a professor of surgery and director of the Penn Transplant Institute.
CHOP's surgeon-in-chief, Dr. N. Scott Adzick, states that the ability to plan and carry out this type of surgery is testament to the skill, expertise and passion of the staff at CHOP.
"I am extremely proud of Dr. Levin and his team for their courage, dedication and expertise," he adds, "and appreciative to Zion and his family, whose bravery and trust in this clinical team is truly inspiring."
Previously, Medical News Today reported on another recipient of groundbreaking transplant surgery. Last month, it was announced that the recipient of the world's first successful penis transplant was due to become a father.