Indiana woman undergoes double hand transplant

Indiana woman undergoes double hand transplant

Louella Aker, 69, becomes first female hand transplant recipient in Kentucky; video of the procedure can be found at https://youtu.be/5q329IX2Vcs.
Indiana woman undergoes double hand transplant

Louella Aker is seated with from left, Christine Kaufman, Ph.D., Stuart Williams, Ph.D., and Tuna Ozyurekoglu, M.D.

A Jeffersonville, Ind., woman has become the first female hand transplant recipient in Kentucky and the 10th patient to receive a hand transplant from the Louisville Vascularized Composite Allograft (VCA) program, a partnership of physicians, researchers and health care providers from the University of Louisville, Jewish Hospital, part of KentuckyOne Health, the Christine M. Kleinert Institute for Hand and Microsurgery (CMKI) and the Kleinert Kutz Hand Care Center.

During a 17-hour procedure on Sept. 17, Louella Aker underwent a double hand transplant at Jewish Hospital. The 69-year-old acquired an infection while involved in the cleanup of Henryville, Ind., after an EF4 tornado hit the area on March 2, 2012. Aker was later diagnosed with septicemia and underwent a bilateral, below-the-knee amputation on her legs, left forearm amputation, and right partial hand amputation. Aker was added to the organ donor registry in September 2015.

“There are so many things you cannot do without your hands. This will change my life and allow me to do the things I miss, like holding my granddaughter’s hand,” Aker said at a news conference on Oct. 19. “I spent many days praying for a donor, but also crying for the donor’s family for their loss. This is such a huge and exquisite gift they have given me and I thank and bless them for their sacrifice. I also want to thank the surgeons, my family and my church for their support.”

Twenty surgeons from UofL, CMKI and Kleinert Kutz performed the procedure. Fourteen staff members and six anesthesiologists also assisted with the surgery.

“Although a little slow, we are pleased with the progress that Louella has been making,” said Tuna Ozyurekoglu, M.D., lead surgeon on the procedure and assistant clinical professor of orthopedic surgery at UofL. “She is truly a fighter who has continued to grow stronger each day following this surgery. We look forward to watching her return to her normal activities, as she shows the world how successful transplantation can be.”

“Operations such as this help demonstrate the enormous importance of organ and tissue donation,” said Christopher Jones, M.D., associate professor of surgery at UofL and director of abdominal transplantation at Jewish Hospital. “If it were not for the donor family graciously agreeing to limb donation, the efforts of Kentucky Organ Donor Affiliates and neighboring organ procurement organizations, this certainly would not have been possible.”

Aker was placed on immunosuppressive medications to prevent rejection of the new hand.

“She is tolerating her medications, and to date, has no signs of clinical rejection,” said Jones, who is overseeing the patient’s immunosuppressive therapy by closely monitoring her for signs of rejection and adverse reaction to medications.

“It is amazing to be part of an extraordinary team, performing procedures such as this double hand transplant,” said Stuart K. Williams, II, PhD, director, Bioficial Organs Program, Cardiovascular Innovation Institute. “New innovations developed by investigators at the Cardiovascular Innovation Institute are being translated to help patients recover more quickly from transplant surgery.”

The Louisville team developed the pioneering hand transplant procedure and has performed hand transplants on 10 patients since 1999. The clinical trial is led by Ozyurekoglu with research at the CMKI and the Cardiovascular Innovation Institute, a partnership of UofL and the Jewish Heritage Fund for Excellence.

Funding for the surgical procedure was provided by the Jewish Hospital & St. Mary’s Foundation, part of KentuckyOne Health.

The success of the Louisville VCA program has led to additional funding for ongoing transplantation and research. Early funding for research on composite tissue allotransplantation and immunotherapy from the Jewish Hospital & St. Mary’s Foundation helped bring about the nation’s first hand transplant. Other hand transplants were funded by the Department of Defense.

In late 2012, the Jewish Hospital & St. Mary’s Foundation allocated $1.5 million for the Louisville VCA program to bring potential hand transplant recipients to Louisville for screening, hand transplantation surgery and patient therapy and rehabilitation after surgery.

In 2013, the Louisville VCA program was awarded $850,000 to fund a clinical trial of a new treatment that will help prevent rejection of hand transplants as part of the Armed Forces Institute of Regenerative Medicine (AFIRM) research program. AFIRM II is a five-year, $75 million federally funded project that will focus on applying regenerative medicine to battlefield injuries. Results of this trial will be far-reaching and benefit not only military patients, but all hand transplant recipients.

The AFIRM II funding enables Louisville VCA researchers to explore the potential for a cell-based therapy to help control the immune system’s response to a hand transplant, with a goal to lessen or eliminate the need for immune-suppressant drugs.