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Soldier Who Lost Four Limbs Gets Double-Arm Transplant

The first U.S. army soldier to ever survive losing all four limbs in the Iraq war has now received a rare double-arm transplant at Johns Hopkins Hospital in Baltimore.

Brendan Marrocoo, age 26, of Staten Island, N.Y., underwent extensive surgery last month, becoming the first service member from the Afghanistan and Iraq wars to survive becoming a quadriplegic, according to officials.

Injured by a roadside bomb on Easter Sunday in 2009, Marrocoo lost both his legs above the knee, his left arm below the elbow, and his right arm above the elbow.

Additionally, he received bone marrow from the same deceased donor who supplied his new arms. The infusion allowed doctors to decrease the number of strong anti-rejection drugs they would normally use from three to one.

The military is sponsoring surgeries like this one to help injured soldiers. Around 300 military personnel have lost hands or arms during these wars. Marrocco is one of only seven people in the United States who has undergone successful double arm transplants.

Performed on December 18, the surgery lasted 13 hours. It will be a year before doctors know to what extent Marrocco will be able to function using his new arms.

The operation was led by Dr. W.P. Andrew Lee, chief of plastic surgery at Johns Hopkins. Lee, who has previously led double-hand or double-arm transplants, said Marrocco’s “was the most complicated one” so far.

In total there have been around 80 arms transplants in about 60 patients throughout the world. In the U.S., there are hundreds more military amputees who have lost up to four limbs.

In 2008, a double-arm transplant was completed in Munich, Germany, on 54-year-old farmer who lost his arms in an accident. The doctors from that surgery noted that the most complicated aspect to it was making sure blood flow was established between the muscles in the new arm and the patient’s body.

Many of these wounded soldiers have been treated at Walter Reed Army Medical Center, Marrocco included, as well as two other quadruple amputees who are still there.

Several of these patients have been fitted with advanced, mechanical prostheses, however, Dr. Lee notes that younger amputees don’t always use them.

Limb transplantation, regardless of its psychological, medical, and logistical complexity, holds great potential for the future.

Lee said that as of now, the results of Marrocco’s transplants have been good. The arms will never give him 100 percent normal function, however, former patients have relearned how to use chopsticks, tie their shoes, and put their hair in a ponytail.

Lee said in addition to the physical result:

“I think it also has additional advantage for the patient to be restored whole. Once they’re transplanted, they regard the arm as theirs. And I think they’re more comfortable going out on social occasions, as opposed to wearing a prosthetic.”

There will be a press briefing on the double-arm transplant with Marrocco and his surgeons later this morning.

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