At eight years old, Zion Harvey became the first person to receive a pair of donor hands in a groundbreaking transplant operation. Two years later, his doctors have published an update on his progress, revealing that while the transplant was a success overall, there remain many challenges and risks in this nascent area of medicine.
As a toddler, Zion lost his hands and feet after a bacterial infection he’d contracted developed into sepsis. In addition to his amputations, his kidneys also failed, necessitating a partial kidney transplant. After his body was able to recover from both the sepsis and kidney transplant, doctors decided that he might be the right candidate for something novel and a little bit risky: a bilateral hand and forearm transplantation that took a team of 40 medical personnel almost 11 hours to complete.
The transplantation was a success, although it has been an uphill battle for Zion. By about one year after the surgery, he could hold a baseball bat, and by 18 months after the procedure, he’d made even further marked progress. Today, his movement is more coordinated and powerful, and the motion between his right and left hands is in tandem.
Zion can also write as well as feed, dress, and go to the bathroom himself more independently than before the procedure. Unfortunately, he has also experienced eight rejection episodes, during which his body’s immune system mounted a defense against the transplanted tissues. These episodes have been managed mostly with medications, in addition to Zion’s continuing physiotherapy. Researchers are hoping that, by studying the ways that the child’s body recovers from each setback, they will be able to improve the process for future patients.
Hand transplantation was first attempted, unsuccessfully, in the 1960s. More than 100 people have had one or two donor hands transplanted since that time, with varying degrees of success. A milestone in the process came in 2000, when Malaysian surgeons transplanted the arm of a deceased infant onto her identical twin. Zion’s success in 2015 has provided ample learning opportunities for researchers in the field, especially since he was older than the infant in the Malaysian case, and therefore his brain development was not optimized to adapt as much.