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Hand Transplant Recipient Released From Jewish Hospital - Biopsy Shows No Rejection

For Immediate Release: 7/21/2008

For Immediate Release: July 21, 2008

HAND TRANSPLANT RECIPIENT RELEASED FROM JEWISH HOSPITAL - BIOPSY SHOWS NO REJECTION
Transplant Procedure Performed July 12 at Jewish Hospital Hand Care Center by Kleinert, Kutz and Associates and University of Louisville Surgeons

LOUISVILLE, KY – Dave Robert Armstrong, the nation's fourth hand transplant recipient, continued to show progress in a series of developments through the weekend. The medical team representing the University of Louisville, Kleinert, Kutz & Associates and Jewish Hospital spent several hours with Armstrong performing the first biopsy on the transplanted hand and beginning physical therapy.  He was also released from the hospital.

According to Warren Breidenbach, M.D., lead hand surgeon and Kadiyala Ravindra, M.D., lead transplant surgeon, the biopsy showed no signs of rejection. Another biopsy procedure is expected to take place tomorrow.   The biopsy procedure consists of removing a very small piece of tissue from the back of the transplanted hand and the forearm. The Jewish Hospital pathology laboratory then analyzes the biopsy.  Nerve endings have not fully matured, so a local anesthetic is not necessary.

Ravindra stressed the importance of Armstrong being the second hand recipient to receive Campath to avoid the use of steroids that can cause complications. “The first two hand patients used three immunosuppressive drugs, one of which was a steroid.  One patient suffered complications from the steroid use. With Dave, we want to avoid the use of steroids.”

In addition to the biopsy, Armstrong was outfitted with an orthotic brace called the "Crane Outrigger." The brace will allow his hand to continue to heal yet control the movement of his fingers during therapy.

Armstrong spent a few hours Friday, Saturday and today with his three therapists, Ann Hodges and Laurie Newsome, both physical therapists, and Ashley Buren, occupational therapist, to begin therapy. All three are with the Christine M. Kleinert Institute. He will continue hand therapy two hours-per-day, six days-a-week.

"I'm quite pleased with Dave's finger movement at this point," said Newsome.
Following his discharge this weekend from Jewish Hospital, Armstrong will stay in the Louisville area for about three months to continue his therapy sessions.

The 18-member transplant team included surgeons from Kleinert, Kutz and Associates, the University of Louisville and Jewish Hospital Hand Care Center, as well as a two-member team from Anesthesiology Associates and Medical Center Anesthetists. Kentucky Organ Donor Affiliates, an organ procurement organization, coordinated the donation of the hands for both recipients. The group of surgeons performing the innovative procedure also performed the world’s first successful hand transplant in 1999, the nation’s second in 2001 and the nation’s third in 2006. To date, there have been a total of 39 hands transplanted on 31 patients around the world.

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Barbara Mackovic
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Jewish Hospital & St. Mary's HealthCare Kleinert Institute Kleinert Kutz Hand Care Center University of Louisville School of Medicine