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World's First Quadruple Limb Transplant Fails 124

Posted by samzenpus
from the not-this-time dept.
New submitter smoothjazz writes "The world's first quadruple limb transplant failed, according to Hacettepe University. Doctors had to remove the arms and legs that had been transplanted last Friday onto Sevket Çavdar, 27, because of tissue incompatibility. From the article: 'Doctors had first removed one leg from the patient after his heart and vascular system failed to sustain the limb and then the other leg and two arms. "The science council (of the hospital) decided to remove the organs one by one due to additional metabolic complications in the following process," the hospital said in a statement. "Our patient is now in the intensive care unit. The critical process is still continuing," it added.'"
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World's First Quadruple Limb Transplant Fails

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  • by durrr (1316311)
    The black knight was not just a fictional person?
  • by Dan East (318230) on Monday February 27, 2012 @01:34PM (#39174411) Homepage Journal

    Anyone else notice the similarity between "Çavdar" an "cadaver", in a story that already parallel's a certain work by Mary Shelley in a number of ways.

    • I also noticed that the summary has "evket" while the article has "Sevket". Is it yet another character that Slashdot's administrators refuse to allow in Slashdot's character set?
      • by g0bshiTe (596213)
        Don't you mean lahdot'?
        • by tepples (727027)
          Almost. The name of Slashdot uses ordinary S characters without cedilla, which are on the whitelist.
    • by Amouth (879122)

      yea it got me at first - i was trying to figure out how they failed to transfer limbs to a "cadaver" and then couldn't figure out why the hell you would do that.. then i realized it was the guys name "Çavdar"

      • Maybe it's has a different meaning in Turkish, but I, for one, would not like to run around with that name.

        Especially with this Zombie thing that's taking over. Just a bad idea all around.

    • Re: (Score:3, Informative)

      by Anonymous Coward

      That character is equivalent to the "ch" sound in English. His name would be pronounced as Shevket Chavdar.

      • That character is equivalent to the "ch" sound in English. His name would be pronounced as Shevket Chavdar.

        Nice try but it needs further clarification. "Ch" as in "school" or ch "branch">?

    • Why didn't they just do it one limb at a time. Sounds like showing off and malpractice to me. Too many Dr. Frankensteins, too few people who understand the spirit of the Hippocratic oath.
      • Probably because it's hard to find a compatible doner. That and all the parts matched. Would suck to get one leg from a 6'4" person and the other from a 6' person.
  • I'll admit I'm no doctor, but I don't think I'm that out of touch to have missed an announcement like being able to splice/repair nerves. *starts timer to see how quickly I'm proven to be out of touch*
    • by Scootin159 (557129) on Monday February 27, 2012 @01:46PM (#39174563) Homepage
      Limb transplants are nothing new: http://en.wikipedia.org/wiki/Hand_transplantation [wikipedia.org]
      • by sconeu (64226)

        And they've been reattaching severed limbs since the '70s. My friend's dad had his arm reattached after a boating accident circa '76. He was one of the first.

        • by x0 (32926) on Monday February 27, 2012 @02:41PM (#39175289) Homepage

          And they've been reattaching severed limbs since the '70s. My friend's dad had his arm reattached after a boating accident circa '76. He was one of the first.

          Re-attaching someone's own tissue, I think, doesn't have anywhere near the challenges of a limb transplant. I have a BK leg amputation, and have been wearing a prosthetic sine 1995. I asked the ortho surgeon at the time whether or not a transplant was viable, and back then the answer was 'no'.

          Having read this article, I have started to reach out once again to see what the possibilities are.

          m

          • by sconeu (64226)

            The OP's question was about nerve reattachment, which is the same whether it's your own or someone else's.

            • by x0 (32926)

              The OP's question was about nerve reattachment, which is the same whether it's your own or someone else's.

              If it were that simple (relatively speaking), you would think that limb replacements would be relatively common. That they are not informs me there are challenges above and beyond mere nerve and tendon re-attachment.

              m

              • by DarkOx (621550)

                I would have to guess you are correct as well. When you think of all the people who have prosthetic legs and how uncomfortable those are supposed to be. I would expect if it were possible to use donor tissue lots of people would choose it. Even if the nerves and tendons could not get attached a paralyzed limb say from the knee down would be better than the prosthetic alternatives for many patients.

                You might not get as much potential function out if; but you would not have the painful chaffing, binding, a

      • by Bios_Hakr (68586)

        That's mostly controlled by muscles/tendons in the forearm. They mention some nerve repair, but I doubt they really mean it in the way we think they mean it.

        If this had worked, he'd have been exactly as bad off as before. He would have just looked *slightly* more normal and been a *much* greater burden on his caregivers.

        • by canajin56 (660655) on Monday February 27, 2012 @02:43PM (#39175307)

          I doubt they really mean it in the way we think they mean it.

          What do you think nerve repair means? If you think it means using very tiny thread to suture the nerve sheath, while being careful not to suture the inner portion, then that's exactly what it means. The nerve itself will knit on its own. It's been done for a long time. You can find surgical manuals from the 30s that document proper nerve suture techniques. The first documented nerve suture was performed in 600 AD (though I can't find reference to the effectiveness of it). Microsurgery techniques have made great strides since then. And I believe that the major nerves will be in a larger bundle for an above-elbow arm transplant compared with a hand transplant, so this situation is actually easier than the hand transplant cases (though peripheral nerves are another story altogether). At any rate, nerves also regrow all on their own, though for an arm it can take 2-3 years of slow progress. There have been several above-elbow arm transplants that resulted (after 2 years recovery) in full elbow mobility, limited but useful sensation, and extension and flexing of fingers and thumb. (Citation for one such transplant [wiley.com], full article may be behind paywall).

          The problem with nerve regrowth in transplants is that sometimes they just don't, though in 2009 French doctors discovered that they can trigger regrowth by manual stimulation of the motor cortex using magnetic impulses. The theory being that nerves that aren't being used by the brain anymore won't regrow, so if the amputation was not recent, the nerves won't grow without a jump start straight to the brain.

          Above elbow/knee transplants can also have the problem that that much vascular bone marrow greatly increases the chance of graft-versus-host. Though apparently it can also lead to the opposite result, with the host accepting the graft tissue more readily.

    • by Mithent (2515236)
      It's not as far-fetched as it sounds: the first limb reattachment was of an arm, in 1962. The patient apparently had function and sensation in the arm, and could lift 20 pounds with it.
    • by Mabhatter (126906) on Monday February 27, 2012 @01:56PM (#39174721)

      They can repair the gross nerves now... Of course in limbs they are fairly spread out.... At least enough to gain some mobility.

      You're not going to play piano, bit at least you can feed youself and wipe your own ass again!

      I'm curious how they thought the heart was going to support the limbs... That's like 80% increase in body mass when the body had adjusted to not havin any limbs. Would you even have enough blood in your body to pump??? Had they done one it probably woul have worked... The problem is how to keep te others alive until they can be attached... Otherwise 4different doners would be even worse.

      The future is in the big black robot suit....

      • by mikael (484) on Monday February 27, 2012 @02:22PM (#39175021)

        They were advertising for volunteers to donate enough blood for that guy. What are the psychological effects of having more "body" that is not you, than is you? There was even an organ transplant of the more private parts, but the man's wife has psychological objections after the transplant.

      • by mitzoe (2531020)

        The future is in the big black robot suit....

        NOOOOOOOOOOOOOO!

        • How many of you who actually watched the movie tried to keep yourself from laughing at the scene, in fear that there may be some unstable guy behind you who actually thought they just watched a good movie.
    • by afidel (530433)
      Sure, my dad sliced right through a nerve bundle while slicing the turkey on Thanksgiving a few years ago. The ER doc did a passable enough job of stitching him up but he noticed severe sensory problems with the thumb along with some movement problems when he took off the splint a day or two later. He went to a specialist and the guy ended up doing microsurgery to repair the nerve bundle as well as to do a better job of re-attaching the tendon.
  • They removed WHAT? (Score:4, Insightful)

    by freeze128 (544774) on Monday February 27, 2012 @01:39PM (#39174471)
    Since when is an arm or a leg considered an ORGAN?
    • by Anonymous Coward

      Since always...

    • by Anrego (830717) *

      I’m no doctorb, but I believe the most technical medical explanation for an “organ” is: a bunch of stuff joined together which does something.

    • Since the internet happened and joes of all sorts think they are "journalists".
    • Since when is an arm or a leg considered an ORGAN?

      Typical guy thinking.

    • by Baloroth (2370816)

      Since the term "organ" means "tool". Literally. Also, since Wikipedia defines it as "a collection of tissues joined in structural unit to serve a common function." So, yes, an arm or a leg is an organ, most definitely, just not the kind of organ most people think of as "organs."

      • by jklovanc (1603149)

        Yet again Wikipedia is not the final word on the world's knowledge. There is one main issue with calling a limb an "organ" is that it contains only part of another well difined "organ"; skin. Skin the the biggest organ in the human body and one can not have part of one organ be part of another organ. If you want to bring up the veins and arteries; ther are not organs but a system.

        Another point is that the fact that there are bones in a limb breaks the "structural unit" clause. The arm bones are only part o

        • by Baloroth (2370816)

          Skin the the biggest organ in the human body and one can not have part of one organ be part of another organ.

          Why not? The penis is an organ by every definition (common and medical) I can find, and it most certainly includes another organ (the skin, unless you want to try arguing the skin isn't part of the penis, which would be an odd argument). Also, the ear (absolutely an organ) includes skin as well. The arm is more usually considered an "appendage" and medically speaking it might be more precisely called an "organ system" or part of a system. And the arms certainly perform special functions (grasping objects).

    • by Joce640k (829181)

      Your skin is an organ...

    • by GodInHell (258915)
      Since calling them "members" would make the journalists snicker.
  • Well, they were trying to make the first voltron. Perhaps they didn't go through the checklist... Activate interlocks! check. Dyna-therms connected. check. Infra-cells up; check. Woops, forgot the megathrusters. ABORT
  • at the same time in the first place? Sounds like a bit of shameless headline grabbing to me.
    • by DougBTX (1260312)
      I was thinking that too, but then, what about the donor? Presumably doing them all at once would have given they guy a matching "set".
      • by spads (1095039)
        Yes, that bares consideration. Hopefully they had a good reason for it, though that business about them being an up and coming transplant center (eg. "first face") does make one wonder.
    • by berashith (222128)

      could be that they got all 4 at the same time, from the same place. Recovery would be difficult enough without having different strengths and dimensions to the added parts, and I dont know how long these would keep without being attached to a living something.

      • by afidel (530433)
        There's also the fact that even a single limb would be a major freaking surgery and there are very significant risks to any major surgery so it might give better odds to have one long marathon surgery instead of four major surgeries.
    • by mikael (484)

      China is pleased to announced the first successful head, torso, legs and arms transplant completed without any loss of blood or complications. The entire operation was completed in record time and avoided the use of any invasive surgery. Within hours of completing the procedure, the patient was able to stand up and walk around.

    • by nusuth (520833)

      I can see the logic of using all organs of a suitable donor but few doctors who commented on this operation all said it is too ambitious. Which proved to be the case, he is dead now.

  • by pecosdave (536896) * on Monday February 27, 2012 @01:49PM (#39174613) Homepage Journal

    Even as a non-doctor I realize that adding that much body mass to Bob or Art or whatever his name was would stress his system that wasn't used to it.

    After doing some arm cardio for a while with a stable patient probably a year or more later, then maybe legs. It would probably take at least that long to find the next donor anyway.

    • by Hentes (2461350)

      It would probably take at least that long to find the next donor anyway.

      When there is a donor they usually have four limbs, my guess is that the doctors didn't want the rest of it go to waste.

    • by Anonymous Coward

      Even as a non-doctor, I realize that fiddling with the internals of a human body would stress the system that isn't used to it. Obviously surgery is too dangerous and harmful! We should stick to proven treatments such as tiger testicles and baby livers.

  • by schlachter (862210) on Monday February 27, 2012 @01:49PM (#39174617)

    I wonder if it would have had a higher chance of success if they had only transplanted one or two limbs? Seems like it would have been less strain on his vascular system. Anyways...very sad.

    • by Mithent (2515236)
      Sounds like it would have been a better idea. It must be difficult enough to for the body to adapt to one newly-attached limb, let alone 4 at once.
    • by ColdWetDog (752185) on Monday February 27, 2012 @02:04PM (#39174821) Homepage

      The whole thing sounds terribly weird. Where do you find a person who, acutely, loses all four limbs? If it's traumatic, then the chances of them surviving the accident or whatever are pretty slim, much less four limb reattachments. If it's congenital then why do all four at once? Maybe you think you have a good donor (although it seems like that is wrong, FTFA)?

      Searching the Internet and avoiding Fox News and the Daily Mail, I found this link [todayszaman.com] which shows a picture of the patient - he's in a wheelchair and he clearly has some deformity in his hands, so this may well have been congenital. The donor (a motorcycle accident victim, remember that fellas, in the industry we do call you all 'organ donors' for a reason) also donated his face to another transplant.

      Just hope to hell he had a clear understanding of what he was getting into.

      • by nbauman (624611)

        Where do you find a person who, acutely, loses all four limbs? If it's traumatic, then the chances of them surviving the accident or whatever are pretty slim, much less four limb reattachments.

        It happens occasionally. One way is massive soft tissue infection, to which the arms and legs are particularly sensitive. One woman had that happen to her after childbirth. Another way is blood clots throughout the body, that particularly affect the arms and legs.

        One of the body's survival mechanisms in extreme cases is to withdraw blood circulation to the arms and legs, so the limbs are particularly vulnerable.

        These are terrible diseases in which most people die, so the doctors thought it was an accomplish

  • by Anonymous Coward

    He never asked for this.

  • by Anonymous Coward on Monday February 27, 2012 @01:55PM (#39174697)
    ...but the patient is completely stumped.
  • However most here don't seem to grasp that having (seriously) unmatched legs would be a nightmare for a normal person, let alone one that is trying to rehab from complete amputation.

    It's one thing for the leg to be slightly different length, but different muscle tone, length, bone structure (obviously not gross structure) would make rehab all but impossible.

    I do however find it a little odd that they felt the need to do all four at the same time... surely the odds of success would have higher doing the legs

    • by Daetrin (576516)
      I agree, the proposal to do it one limb at a time, presumably from four different donors due to the amount of time between operations, isn't very feasible.

      However it seems like starting with two arms would be the way to go. First because they draw less blood than the legs, so there would be less for the vascular system to adapt to. Second because if i was a quadriplegic and had the choice of getting just my arms back or just my legs back, i'd definitely opt for the arms. If you've just got arms you can al
  • Such a shame, probably has the highest hopes for a better life and may not survive now.
  • by StikyPad (445176) on Monday February 27, 2012 @02:21PM (#39175005) Homepage

    Doctors had to remove the arms and legs that had been transplanted last Friday onto evket Ãavdar, 27, because of tissue incompatibility.

    I look forward to the day where limbs and organs can be lab-grown from a patient's own cells and we won't have to worry about tissue rejection. While sad, I hope these sort of stories can at least help to inform the public of the promise that tissue engineering holds. The overwhelming majority of deaths in the US are a result of organ failure, whether due to cancer, heart disease, or other chronic illness. The ability to replace organs and tissue with their lab-grown counterparts would be a huge boost to both life expectancy and quality of life for a significant portion of the population.

  • I'm wondering what sort of hospital this was.

    Is it the local equivalent of the best in breed hospital, or it just some local hospital where the surgeon ran amok and no protocols were followed?

  • ...as "World's First Quadruple Limb Transplant FLAILS", which would have been a positive sign.

  • removed one leg from the patient after his heart and vascular system failed to sustain the limb and then the other leg and two arms. "The science council (of the hospital) decided to remove the organs one by one

    Wow. From a quick scan of the summary, it sounds like they took out everything but the guy's chassis. Leg, leg, arm, arm, and then the next sentence about removing organs one by one? Can his family visit him in the head museum?

  • Sounds like a trip into Dead Space [ea.com]. The good news is those limbs can be used as weapons.

  • R.I.P. (Score:3, Informative)

    by Anonymous Coward on Monday February 27, 2012 @03:36PM (#39176169)

    It is reported by Turkish news that the guy just passed away.

  • by syntap (242090) on Monday February 27, 2012 @07:26PM (#39179445)

    The patient has passed away according to reports.

    Was it too much to take on at once? I'm not referring to four limbs on one patient, I'm referring to four limbs on one patient PLUS a face transplant the same day by the same team.

    "Meanwhile, the face transplant patient, who was operated on by the same team of surgeons on the same day, was reported to be in good condition. "

    http://www.hurriyetdailynews.com/quadruple-limb-transplant-patient-dies.aspx?pageID=238&nID=14816&NewsCatID=341 [hurriyetdailynews.com]

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