Double-Arm Transplant: Medical Miracle or Wave of the Future?

Transplants have been around for many years.  However, it is not too often that you hear about a “limb” transplant, much less a double-limb transplant.  But that’s what has just occurred with a 54-year old German farmer who was given a double full-arm transplant after an accident in which he lost both limbs. Is this a medical miracle, or wave of the future?

The double-arm transplant was performed at a hospital in Munich, Germany. 

The farmer had actually lived without arms for six years prior to the surgery. His attempt to use artificial arms failed, at which point he contacted the Munich University’s Rechts der Isar Clinic.

It remains to be seen if the transplant is a success, but the surgery seemed to go well and the man is now recovering.  The procedure involved 40 surgeons and healthcare professionals and was headed by Professor Hans Gunther, Dr. Christoph Hohnke and Prof Edgar Biemer. It was an intense surgery of 15 hours.

The teams were divided up into groups for each the donor and the recipient (the donor was a 15 year old boy).  Before the donor could be cut, the arms were injected with a preservation solution.  Then the arms had to be severed at the exact point as the recipient’s blood vessels to ensure a “perfect fit.”  Amazingly, as soon as the arms were attached, they turned to their normal color.  Next, the tendons, muscles and nerves were connected.  The final part of the procedure consisted of attaching the skin.

Biemer says that the most complicated part of the entire procedure was to make sure that blood flow began to take place between the muscles in the new arm and the body.  If blood could not flow through the arm, the arm would not survive.

What are the chances of this transplant being a success?
The chances are lower for success with a limb transplant than an organ transplant.  Therefore, the next step is to watch to be sure the farmer’s body does not reject the transplanted limbs.

His nerves will expand at 0.04 inches per day until there are enough nerves to start moving his arms and hands.  The process is long and it will take some time before he will get any sensation in his fingertips. In fact, it’s estimated that the farmer will not be able to move his hands for at least a couple of years.

Transplant Trial and Error
The first documented human transplant was a kidney transplant in 1933.  This transplant was not a success.  The very first successful kidney transplant was in 1954 where one twin gave the other twin a kidney. It was actually a success despite the absence of anti-rejection drugs.  The first successful liver transplant was in 1967 in Denver.  The first heart transplant occurred in 1968. 

The Donor Card was created in 1968 allowing families to consent or refuse donation.  The Donor Card also prohibited doctors from participating in organ removal or transplantation. Other government measures were passed to protect donors and recipients, such as the Uniform Brain Death Act in 1978 and the National Organ Transplant Act in 1984.  

While there haven’t been many successful limb transplants thus far, it seems the tide may be changing. With the advances in medical technology and science, it’s quite possible that limb transplants could become as commonplace as organ transplants. Hopefully those advances will prove to be successful in this German farmer.