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July 13, 2011

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Man in first double leg transplant may walk soon

A young man who underwent the world's first double leg transplant might be able to walk with the aid of crutches in six or seven months if his rehabilitation goes well, the surgeon who oversaw the operation said yesterday.

Dr Pedro Cavadas said the patient is a man in his 20s who lost his legs high above the knees in an accident, but gave no other details on him or the donor.

The surgery started on Sunday night at a hospital in Valencia in eastern Spain and lasted 10 hours. Cavadas told a news conference the patient was elated upon seeing his new limbs.

Other doctors not involved with the surgery said the coming days were crucial to establish strong blood supply in the patient's new legs.

"That is the priority now," said Dr Nadey Hakim, surgical director of the West London Transplant Unit at Hammersmith Hospital. "If the blood supply stops, the limbs are gone."

Hakim reckoned that if all goes well, the patient might have 60 percent use of his new legs, based on the amount of function patients of hand and arm transplants have been able to regain. "Whether he will obtain any strength in his transplanted leg muscles is a key question," he said.

Cavadas said the key to the long period of rehabilitation that lies ahead will be how his nerves regenerate and join up with structures like muscles, joints and skin. Cavadas said he imagines the patient will be able to walk with crutches and perhaps even without crutches over the long term. But this depends largely on the physiotherapy process.

"If everything goes as we hope it does, it would be realistic to think that in six or seven months he could be walking" with crutches, Cavadas said.

Still, other experts thought it might take a year or two before the patient is able to use his legs. "Nerve regeneration usually occurs at the speed of about an inch a month," said W. P. Andrew Lee, chairman of plastic and reconstructive surgery at Johns Hopkins University School of Medicine.

He said it was uncertain just how much use the patient would get out of his legs and if the patient doesn't regain feeling in his legs, he wouldn't be able to walk.

He also questioned whether the potential benefits from the procedure outweighed the risks, as the patient needs to take anti-rejection medicines for the rest of his life.





 

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