Ex-Marine makes progress after hand transplant

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The irony, Joshua Maloney said yesterday, is that he served two tours of duty in Iraq as a Marine combat engineer "and I never even caught a cold."
Then, while setting up a training exercise at the Marine Corps Base Quantico in Virginia on Jan. 31, 2007, the Bethel Park native was holding a quarter-stick of TNT in his right hand when it accidentally exploded.
That is what led him to become the first patient ever to receive a hand transplant at UPMC, and only the sixth to get one in the United States.
At a news conference at University of Pittsburgh Medical Center Montefiore this week, Maloney's doctors said he has shown no signs of rejection in the 18 days since his surgery and is making good initial progress in his therapy and treatment.
The transplanted hand came from an 18-year-old West Virginia man who died of head trauma, said Susan Stuart, president and CEO of the Center for Organ Recovery & Education. The man's family also donated his liver, kidneys and some tissue.
With his right arm in a sling and his new hand in a flexible splint, Maloney said he had thought a lot about his donor.
"Honestly, I'm going to be 25 years old this month, and it's terrible that somebody 18 years old is dead. But he was a good enough person to be willing to donate and help other people. I feel for his mother. I say my prayers and I thank God for him and ask God to watch over his mother. What else can you do? I appreciate what he did."
Maloney can wiggle his new fingers slightly, but has no sensation in the hand, and won't for months to come, said his chief transplant surgeon, Dr. W.P. Andrew Lee.
Even though the bones, tendons, blood vessels and major nerves of the new hand and Maloney's arm have been connected, the internal nerves that will control the fine muscle movements of the transplanted hand still have to extend into the tissue from his arm, and they grow at a rate of about one inch per month, Lee said.
There have been about 40 hand transplants around the world. In the United States, the other five were done over the past decade at the University of Louisville.
The lead transplant surgeon in Louisville, Dr. Warren Breidenbach, said yesterday that his team's experience has shown it possible to transplant functional hands to people who have lost theirs in traumatic accidents, and to keep their bodies from rejecting the new tissue.
In fact, Breidenbach and Lee said, the real challenge today in hand transplants is not the surgical techniques needed to attach the limbs, but minimizing the amount of anti-rejection medication that patients must take. Anti-rejection medications suppress the immune system, which can make a transplant patient vulnerable to infections or cancer.

Mark Roth can be reached at mroth(at)post-gazette.com or at 412-263-1130.

(Distributed by Scripps Howard News Service, www.scrippsnews.com.)
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