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Kleinert Kutz Hand Surgeons Perform Fifth U.S. Hand Transplant in Record Time at Jewish Hospital Hand Care Center
Date:11/25/2008

LOUISVILLE, Ky., Nov. 25 /PRNewswire-USNewswire/ -- Kleinert Kutz and University of Louisville hand surgeons performed the fifth U.S. hand transplant on Messina, New York resident, Jan "Erik" Hondusky, at Louisville's Jewish Hospital Hand Care Center on Monday, November 24. The innovative procedure began around noon and was completed shortly after 9 p.m. in a record nine hours.

(Photo: http://www.newscom.com/cgi-bin/prnh/20081125/DC48555-a)

(Photo: http://www.newscom.com/cgi-bin/prnh/20081125/DC48555-b)

The recipient is listed in stable condition at Jewish Hospital. Hondusky, a 43-year-old production worker, injured his dominant right hand in a furnace accident on April 12, 2006 when his hand was crushed and burned thus requiring amputation. He has been using a Myoelectric prosthesis to perform daily living activities.

His wife, Raylene, accompanied him to Louisville. Hondusky also has a stepson and a granddaughter.

A partnership of physicians and researchers at Jewish Hospital Hand Care Center, Kleinert Kutz and the University of Louisville developed the pioneering procedure. Warren C. Breidenbach, III, M.D., with Kleinert Kutz and assistant clinical professor of surgery at the University of Louisville led the team of five hand surgeons, 10 hand fellows and a two-member anesthesiology team from Hand Care Center Anesthesia.

Breidenbach and his team are the only surgeons in the U.S. to perform hand transplants with now five hands transplanted on five men. The first was performed on Matt Scott in January 1999, nearly 10 years ago. To date, there have been a total of 40 hands transplanted on 32 patients around the world.

Kadiyala Ravindra, M.D., assistant professor of surgery at University of Louisville and Joseph Buell, M.D., director, Jewish Hospital Transplant Center, manage the immunosuppressive therapy for all five hand transplant patients performed at Jewish Hospital.

A hand transplant, unlike a solid organ transplant, involves multiple tissues (skin, muscle, tendon, bone, cartilage, fat, nerves and blood vessels) and is called composite tissue allotransplantation.

"The fifth hand transplant went faster and smoother than any of the other previous four," said Breidenbach. "With each case, as it should be, we learn more about how to do it and what to do. We are thankful for all of our hand transplant patient's pioneering efforts, which help us constantly improve the way we help amputees and reconstruct arm and leg defects."

Breidenbach stated, "With each patient we want to do two things -- improve the way we reconstruct the defect and decrease the amount of the immunosuppressive (anti-rejection) drugs. In the last two we have been able to eliminate two drugs we initially used (steroids). On Mr. Hondusky, we are attempting to only use one drug as the initial treatment."

"Once again this demonstrates the bravery of these pioneering men who are willingly to step into a procedure whose outcome is not fully known. Without these pioneers, patients, amputees and humanity would not make progress," Breidenbach added.

Hondusky received one dose of Campath, an immunosuppressive medication, during surgery and will now be on mono-therapy -- one drug to reduce the risk of rejection. "Mono-therapy has been tried once before in another country and it failed, but we have evidence to suggest that it is possible to achieve this goal," said Ravindra. "We will be monitoring him very closely for signs of rejection with weekly biopsies, other laboratory tests and evaluations as needed." Risks associated with immunosuppressive drugs include a higher incidence of cancer, infections and other disorders.

An orthotist and hand therapist will begin bracing and hand therapy within the next few days. Hondusky will be hospitalized at Jewish Hospital for the reminder of the week and then will remain in the Louisville area for the next three months.

Kentucky Organ Donor Affiliates (KODA) worked very closely with the Indiana Organ Procurement Organization to coordinate the hand donation with the family and hospital. Without the help of these organ procurement agencies and the family, this procedure could not have taken place.

The fifth U.S. hand transplant is sponsored by the Department of Defense, Office of Naval Research and Office of Army Research to further research in the composite tissue allotransplantation program.

Information, photography and video are available on our web sites at www.handtransplant.com and www.jewishhospital.org. Video on the website is not broadcast quality.


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SOURCE Jewish Hospital Hand Care Center
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