Investigators recruit subjects for Boston Children's Hand Transplant Program

Boston Children's Hospital today announced that investigators are now recruiting subjects for the world's first pediatric hand transplant program. The Boston Children's Hand Transplant Program, led by principal investigator Amir Taghinia, MD, and William Harmon, MD, is a research-based program that will offer bi-lateral hand transplants for children living without two functioning hands.

The Hand Transplant Program operates under a research protocol reviewed and approved by the hospital's Institutional Review Board. Potential subjects will be children over 10, in good overall health, who for one or more years have been missing both hands. In addition, children who are missing one hand but are already on immunosuppression medication for a functioning solid organ transplant, or missing one hand and the other hand is poorly functioning, will also be considered.

"In recent years, medical knowledge, expertise and technology have evolved to a place where we are able to offer this as an experimental option to patients on a research basis," said Taghinia, who serves as the program's principal investigator and surgical director and has participated in several adult hand transplant surgeries. "We hope that for some children, hand transplants will improve their quality of life, allowing them the ability to be more independent and perform daily tasks—tasks that many of us take for granted."

The complex surgery requires a multidisciplinary team and will be followed by extensive therapy and follow-up care. The process will include a rigorous screening evaluation ensuring that a child is in good health and likely to comply with all treatment protocols.

The program combines the expertise and experience of the hospital's pediatric hand surgeons and the Pediatric Transplant Center. The hospital currently offers programs for Heart, Liver, Lung, Kidney, and Intestine and Multivisceral transplants.

"It has been shown in adults that hand transplants can be safe and effective; the time is right to bring this to a younger population," said Harmon, the co-investigator and medical director of the program, whose body of research has helped form the basis for defining the immune process in organ transplantation. "We know from experience that kids can regenerate nerves better than adults and believe that their immature immune systems can learn to adapt to a transplant successfully."    

To date, only one hand transplant has occurred in a child—a twin-to-twin transplant in Malaysia in which one twin passed away and one of the twin's arms was used to replace a missing limb in the surviving twin. There have been no transplants from a donor to a genetically different pediatric patient.

The transplant team will work with organ procurement organizations in the region and across the country to coordinate the donation process.

"For nearly 45 years, New England Organ Bank has partnered with hospitals to advance the field of transplantation to the benefit of tens of thousands of recipients," said Richard S. Luskin, president and CEO of New England Organ Bank. "We look forward to working closely with Boston Children's Hospital to bring the possibility of hand transplantation to young patients in need."