New technology helping keep transplanted hands attached - wave3.com-Louisville News, Weather & Sports

New technology helping keep transplanted hands attached

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LOUISVILLE, KY (WAVE)- The Jewish Hospital Hand Care Center is known for its success with hand transplants. But when the team's 4th patient, Dave Armstrong had to get his hand amputated in April 2009, the team put on the brakes until they found technology to help them keep transplanted hands attached.

They'd already transplanted a fifth patient, but waited until August 2010 to perform the 6th procedure. The team's first double hand transplant on patient Rich Edwards of Oklahoma. Edwards and now all the hand transplant patients at Jewish are receiving routine tests with the center's new ultrasound biomicroscopy device.

"When you look at the resolution, it's 1000 times at least better" says Christina Kaufman, a veteran research member of the hand transplant team with the Christine M Kleinert Institute.

Purchased with funds from the Department of Defense, Kaufman says it cost "a quarter of a million dollars."

The team is hopeful this research device will prove be the key in detecting potential rejection.

On the surface, the rejection episode in Armstrong happened quickly, "we saw him in March and everything was fine," Kaufman says, "he looked great and then a month later is was disaster."

Armstrong was just 9 months post transplant when surgeons with U of L and Kleinert, Kutz and Associates amputated the rejected hand.

Looking back Kaufman says the team realizes, "that we were doing this, we were blind, we were absolutely blind."

Prior to the ultrasound it required biopsies to get the type of measurements they're tracking. They see muscle, nerves, tendons and can even measure blood flow. What they're most interested in however is a white line found around the artery. It's smooth muscle giving the artery its stiffness, and in Armstrong that is what thickened and prevented blood flow.

"Now that didn't happen overnight," Kaufman says "we do believe it was rejection process, whether it was only rejection we're not really sure about that." What she does feel certain about, "if we caught that early enough we may have been able to intervene."

The intervention would likely be a change in rejection medications. Testing on the first two patients, Matt Scott and Jerry Fisher show they have the least amount of artery thickening and they were on a stronger rejection protocol than Armstrong. Since Armstrong's amputation, the 3rd and 5th patients have added more rejection drugs and Edwards started off with the same protocol as Scott and Fisher.

In the ultrasound test on Edwards, Kaufman finds one small area that she will track to see if any changes occur and if there's a reason for concern.

Edwards, already a veteran to blood flow loss, and rejection will actually lose the tips of his right thumb and pinky. But he's confident with this test, he will keep his new hands. "They use it religiously on all the guys and they're going to catch any little abnormality starts pushing its head out before it becomes a problem."

He too is relying on religion of his own, an unwavering faith. "Who am I" says Edwards, to be this fortunate, this blessed" as he holds up both hands and with tears in his eyes, "but I am thankful."

Edwards hands before the transplant were badly burned in a vehicle fire. The fingers wouldn't bend or straighten. He's now combing his hair, brushing his teeth and just recently he says, "I can now feed myself with a regular fork the entire meal."

He's hoping to regain 80% of the function in his hands. And despite the appearance with two the two blackened fingertips, doctors say he is doing great and plans to head home to Oklahoma for Christmas. It should be a long stay home, at least a couple of months.

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