Arm transplants 'not far off' at Bristol hospitals

A PLASTIC surgeon believes carrying out arm transplants at Bristol hospitals is "not far off".

Frenchay Hospital's Umraz Khan said the technique recently used to replace an American soldier's arms with those of a dead donor is already used in Bristol to attach tissue from one part of a patient's body to another.

And in time he believes there is a chance the regional trauma centre based at Frenchay could benefit from the ability to transplant limbs.

Mr Khan has previously used a patient's toe to recreate a thumb and believes that the team is "almost there" in terms of being able to transplant limbs from a donor but ethics and methods to stop the body rejecting someone else's limb need to be overcome first.

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Brendan Marrocco was the first US soldier to survive losing all four limbs in Iraq and had a double arm transplant at a hospital in Baltimore.

Mr Khan said: "In a way we are almost there. All they have done, not to demean them, is use technology and a technique we have in this hospital.

"This is a case where having a donor that can give you two arms is one thing. When you are using a patient's own tissue you do not need to have any immunosuppressants."

Mr Khan said the micro vascular surgery he carries out to attach tissue from one part of the body to another relies on connecting arteries and tendons in the way that American surgeons would have with the donor arms.

"I think this chap is going to get a very good result," he said.

Mr Khan said he was particularly interested in the use of the donor's bone marrow in Mr Marrocco's case as it could solve the problem of the recipient's body rejecting a new limb.

"It is still experimental but the idea is that if you prime the body with a donor's white cells then there is a way of preventing the recipient's body from recognising the transplant as foreign – and nirvana would be reached," he said.

"We are still, unfortunately, in a position where we have got to give quite powerful immunosuppressants for the rest of the recipient's life."

Mr Khan said that the first UK hand transplant, which was carried out by Prof Simon Kay in Leeds in December, took several years and that for now he would refer Bristol patients there for treatment.

"This area is very rigorously controlled and the team in Leeds had been working on the ethics and morals for a long time and took about five years before they were able to finally undertake it," Mr Khan said.

"If someone came to me now and I thought they might benefit I would not do it in Frenchay I would refer them to Leeds for a transplant.

"But if we crack that nut where the recipient becomes a thing of the past in essence all you are doing is providing the tissue the patient lost through trauma or tumour and it becomes something that can be done nationally rather than at one centre for the UK it is probably not far off.

"Everyone is watching this with bated breath and if they get it to work, I know technically we can do it in Frenchay it is what happens in the immune system."

When that time comes he said it could eventually pave the way for patients coming through the trauma centre to have limb transplants.

"It could be that when someone comes in with a major trauma, it could be a major part of their body or their face or whatever, providing there was a bank of human tissue you could essentially take it off the shelves and transplant it."