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6 December 2014

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Kiwi leads double arm transplant op

Kiwi leads double arm transplant op

US quadruple amputee gets two new limbs in nine-hour procedure.

It took months of planning, a nine-hour surgery and a team of 35 clinicians.

But by the end, they had completed a ground-breaking double arm transplant on a quadruple amputee.

And the man who led the team at a Boston hospital was a 38-year-old Kiwi surgeon from Hamilton.

Dr Simon Talbot, a reconstructive plastic surgeon specialising in hand surgery, trained at the Auckland University School of Medicine.

Now he is the director of upper extremity transplantation at Brigham and Women’s Hospital in the US.

The surgery was the third bilateral hand transplant by the team but the first that included the forearm and above the elbow on one side.

Patient Will Lautzenheiser, 40, became a quadruple amputee in 2011 following a life-threatening streptococcus infection.

In June this year, the former professor of film production and screenwriting at Boston University and Montana State University was approved for the bilateral arm transplant following completion of a rigorous pre-operative evaluation.

The surgery required months of careful planning by specialists at Brigham and Women’s Hospital.

The teaching hospital is a centre for limb transplants and is the only hospital in the US where both face and hand transplants are performed.

Such an operation requires input from up to 15 surgeons, anaesthesiologists, transplant specialists, occupational specialists, physical therapists, nurses, physicians' assistants, scrub technicians, operating room staff and more.

"At any one time we have between 10 and 20 people working together," Dr Talbot said.

At the same time at another hospital, a team of doctors procures the limbs from a deceased donor – who is not identified in this case.

Both surgeries must be co-ordinated and surgeons must work quickly on either side of the donor and recipient to ensure the bilateral transplant goes as quickly and as smoothly as possible.

"So the logistics are really complicated."

It’s hoped that one day, after nerves from the top of his arm grow into the donated limbs, Mr Lautzenheiser will have enough sensation to be able to hold a cup, cutlery to feed himself and possibly even hold a pen.

Before the surgery Mr Lautzenheiser said he was most looking forward to being able to hold and hug his partner, as well as the potential to return to teaching and film-making.

Dr Talbot said seeing the life-changing effects of Mr Lautzenheiser’s successful surgery has been hugely satisfying and rewarding.

"You really recognise you're transforming a life dramatically."

Dr Talbot went to St Paul’s Collegiate in Hamilton, and said he felt incredibly lucky to be working in such a highly specialised level of medicine by being in the US.

"That said there are the frustrations by working in a system like the United States and there are some wonderful things about the New Zealand system.

"New Zealanders are very resourceful and very inventive and I think that really spurs a lot of innovation."

Dr Talbot started out as a house surgeon at Tauranga Hospital before heading to New York in 2002 to further an interest in medical academic research at cancer hospital Memorial Sloan-Kettering.

He later began a plastic surgery training programme through Harvard University, and did a fellowship in hand surgery before joining Brigham and Women’s Hospital.