The United States' fifth hand transplant recipient, Jan "Erik" Hondusky, is heading back home to Massena, New York this week after a three-month stay in Louisville under the care of Kleinert Kutz and University of Louisville surgeons.

Kleinert Kutz and UofL hand surgeons performed the Hondusky's hand transplant at Louisville's Jewish Hospital Hand Care Center on November 24, 2008, during a record nine-hour surgical procedure. Warren C. Breidenbach, M.D., with Kleinert Kutz and University of Louisville assistant clinical professor of surgery, led the team of five hand surgeons, 10 hand fellows and a two-member anesthesiology team from Hand Care Center Anesthesia.

"I cannot wait to get home and pick up my granddaughter with two hands and give big two-handed hugs to all my family and friends, said Hondusky. "This has been an awesome event in my life and I have made many new friends here in Louisville. I cannot thank everyone enough -- the doctors, nurses, therapists, donor family and others who have helped me here in Louisville."

The New York resident is a 43-year-old production worker who injured his dominant right hand in a furnace accident on April 12, 2006, when his hand was crushed and burned thus requiring amputation. He used a prosthetic hand to perform daily living activities before the transplant procedure.

Lead hand transplant surgeon Dr. Breidenbach said, "Erik continues to work on mobility exercises and strengthening the muscle groups in the hand and arm using light weights. Functional activities for grasping, releasing and pinching continue to improve, as well. He can perform such daily living activities as washing his hair with both hands, holding a phone with his new right hand, shaking hands in greeting, opening a door, writing with a pen, grasping a water bottle, throwing and bouncing a ball, and picking up objects three inches wide. He can lift a bucket weighing 12 pounds with his right hand and a 20 pound crate with two hands." Hondusky will continue therapy three times week after returning home.

Kadiyala Ravindra, M.D., University of Louisville assistant professor of surgery, who manages the anti-rejection drug therapy for Hondusky said, "Erik has had a few mild rejection episodes over the past three months, which were not surprising, and we were able to treat each with medication. He is doing remarkably well and we expect him to continue to do so."

Hondusky received one dose of Campath, an immunosuppressive medication, during surgery and is on mono-therapy -- one drug for most of the past three months. Maintaining a patient on one drug as opposed to two or three, reduces the risk of rejection. Risks associated with immunosuppressive drugs include a higher incidence of cancer, infections and other disorders.

"Reducing the number of drugs a patient is on will continue to reduce the risks associated with hand transplantation and we believe we can achieve this with our patients going forward," said Ravindra. "We will also continue to monitor him very closely for signs of rejection with biopsies and other laboratory tests."

A hand transplant, unlike a solid organ transplant, involves multiple tissues (skin, muscle, tendon, bone, cartilage, fat, nerves and blood vessels) and is called composite tissue allotransplantation.

A partnership of physicians and researchers at Jewish Hospital Hand Care Center, Kleinert Kutz and the University of Louisville developed the pioneering procedure. Breidenbach and his team are the only surgeons to perform hand transplants in the U.S. To date, there have been a total of 40 hands transplanted on 32 patients around the world.

Kentuckiana Organ Donor Affiliates (KODA) worked very closely with the Indiana Organ Procurement Organization to coordinate the hand donation with the family and hospital. Without the help of these organ procurement agencies and the family, this procedure could not have taken place.

The fifth U.S. hand transplant is sponsored by the Department of Defense, Office of Naval Research and Office of Army Research to further research in the composite tissue allotransplantation program.

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View drug information on Campath.

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