World's First Quadruple Limb Transplant Fails 124
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.'"
Re:strain on vascular system (Score:4, Interesting)
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.
Re:Would the limbs have ever worked? (Score:5, Interesting)
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.
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Re:Would the limbs have ever worked? (Score:5, Interesting)
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.