First Bilateral Hand Transplant in a Child: Zion’s Story


♪♪>>We have some good news for you. ♪♪>>Close up, far away. Close up, far away.>>Call Zoe, Zion.>>Zoe. Close up.>>Come on, come on.>>I wasn’t, I wasn’t always like this. When
I was 2, I had to get my hands cut off because I was sick. ♪♪ I don’t know what a child hand looks like. It could be this color, or this color. I don’t know. ♪♪>>How to make a muscle.>>Over here, let me see how strong you are.>>We have followed Zion for probably about
a year-and-a-half now, and done extensive evaluations to see if he was a good candidate
for hand transplant.>>So, when I get this hands, I will be proud
of what hands I get. I will be proud.>>I will be too. Because they’re going to
be your new hands. You excited?>>And if it gets messed up…>>It’s not going to be messed up. You excited?>>I don’t care because I have my family.>>As far as we know it’s never been even
attempted in a child. One of the things that’s unique about Zion is that he already had kidney
transplants. He’s on medication for rejection. So essentially we could piggy back off that
same medication. Our concerns about doing these hand transplants in anybody is that
once you do it, the patient has to stay on life-long medications so they don’t reject.
And those medications increase the risk of infection, and they also increase your risk
of having some cancer develop later on in life. And so for a child that’s a very, very
difficult decision.>>Stand up straight. Let me see your arm.
Now, I want you to make a fist for me, like this. Good, relax. When I met Zion, I said, “Why do you want
hands? Zion why do you want hands?” He’s a very, very intelligent young man. He said,
“I want to swing on the monkey bars.”>>My grandmother says I’m smarter than a
lot of grownups. I’m really smarter than a lot of grownups.>>You know that’s sort of a milestone for
a lot of kids. And why shouldn’t he be like another child and, you know, our hope is over
time that indeed he will be able to do that.>>And that’s a TV camera. He wants to know
if he’s on TV.>>This is just like another hurdle that he
jumps. He’s jumped so many hurdles. He’s so amazing. This isn’t the first amazing thing
that he’s done. He’s been doing amazing things since he’s been sick. I don’t know many adults
that can handle half of his life on a-day-to-day basis.>>Like sometimes, I just think some of my
classmates, they don’t mean to say mean things to me, but it just slips out. So either, either
somebody says something to me, and then I just figure it slipped out and they didn’t
mean to say it. Everybody has their own way to thinking things.>>It’s true.>>Each year there are only 15 children, based
on the databases, that would even be eligible to donate hands. And then it comes down to
the organ procurement organizations approaching families at a terrible time, the loss of a
child. Just stop and think about that. So the fact that he was put on the waiting list
for hands in April, and three months later this came along. That in and of itself is
a remarkable story.>>Chrissy called me and she’s like, “OK
we have a match.” I’m like, “Stop playing, Chrissy.” She’s like, “No, I’m serious.”>>We have about 12 surgeons. And, you know,
a whole bevy of nurses, at least eight nurses, circling in and out. And then a team of anesthesiologist. I think at least three or four of them that will be working throughout the night. So,
it’s a large team.>>There’s an expression in surgery, “Preparation
is the only shortcut you need.” And particularly in surgery and in highly complex operations,
you know, we prepare. ♪♪>>So we’re about to get started. Zion has
just come into the room. And they’re starting to put intravenous lines in and get ready
for the surgery. We’ll prepare the donor limbs and the recipient’s sites, and then do the
actual transplantation. So, expect to be here all night, but hopefully at the end we’ll
have two hands on two arms.>>OK, hi>>Good to see you, doctor.>>How are you? Ready?>>Good.>>We’ve rehearsed. We know our steps. We
know each other. We know what we have to do today. And I think everybody assembled here
has committed to this patient and making this a reality for this little boy. We can have
complications. We can fail. We can have troubles. But we’re not planning on it. So, everybody
is familiar with their particular role. And I just want to say in advance, we’ll do our
best and we’re all here together. This is a new arena of reconstructive surgery.
It’s a new arena in transplant surgery. This gives new hope not only to the adults, but
particularly children. There are ethical issues and questions about the implications for that,
but that deceased child’s hands and expression, if you will, will live on in Zion. And that’s
a pretty profound thing when you think about it.>>In the beginning of the operation, we actually
had four teams operating at the same time. And each of them had specific things
they were supposed to do. So they had to find all the structure. Put pre-made tags on
for every single structure that we’d have to repair. And they would have to sew those
onto the nerves, blood vessels, tendons, etc. ♪♪>>It’s one thing to sew adult vessels, which
in and of themselves are small and they require this kind of skill. But the highest echelons
of reconstructive microsurgery take place in children, small children. And my colleagues
who participated in the microvascular aspects of the care are just the best in the world.>>The blade goes here, so we’re going to
have to cut this really short.>>Blood is going across the hook-up here.
And you can see the hand right here starting to pink up. You see the capillary refill?
You see that? See it’s white when I touch it, and then it pinks up. And now that’s starting
to get out to the level of the fingers.>>How’s my baby?>>Zion’s doing great. He’s doing well.>>Just came out to give you an update. So
we’ve gone through a lot so far. You know, we broke this thing in down into four different
parts. We’re on this last part here. So at this point, the hands have already been attached,
so the bones are back together. And Dr. Levin and the other microsurgeons are working on
putting the arteries and veins together. You ought to really make sure that this was
going to work for our patient and work for a lifetime, not just a year. For us this is
not really just a technical exercise. It’s really trying to, you know, restore a better
level of lifetime function for these patients. ♪♪>>I think all of you who know about microsurgery,
and all of you do know that we’re not out of the woods, and this is sort of just the
first step. And we have to be very vigilant, and we have a whole protocol on how to take
care of this little guy, but from the bottom of my heart, thanks. We have some good news for you. Your little
guys has two hands.>>Hi, Zion>>And so, what might we say about Zion Harvey
in 10 years or 15 years? What might we say about this? I hope he is the first of literally
hundreds or thousands of patients that are going to be afforded this operation.>>All right, up, up, up, up, up, nice. No
hands, that’s all you.>>Don’t let me get it.>>Don’t let him take it.>>Don’t let me get it.>>Tug of war.>>He’s in no better place than in The Children’s
Hospital of Philadelphia to make sure he gets through this and does well.>>Me and Zoe want a puppy.>>Where’s the puppy gonna live?>>In my room, where else?

8 thoughts on “First Bilateral Hand Transplant in a Child: Zion’s Story

  1. I applaud everyone in this video. Mom, you are exceptional, your little one is such a beautiful human being who will make a big difference in everyone life’s. He touch my sole and my hearth and made them better. What a team at the hospital, every surgeon with different speciality ,
    nurses, anaesthetist and more orchestrated this long and complicated micro surgery, I salute with all respect they deserve.

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