News

World’s first double leg transplantation is carried out in Spain

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d4541 (Published 18 July 2011) Cite this as: BMJ 2011;343:d4541
  1. María de Lago
  1. 1Madrid

The first double leg transplantation in the world has been performed in Spain on a patient in his early 20s whose legs were amputated above his knees after a car crash.

The transplantation, overseen by the surgeon Pedro Cavadas in La Fe Hospital, Valencia, was approved by the Spanish National Transplant Organisation in May 2010 but was only done overnight on 10 July after the right donor was found. The operation involved more than 50 medical staff and took around 10 hours.

The patient, whose amputations were too extensive for him to have prostheses, is recovering well, said Dr Cavadas on 12 July. “He is happier than God. He burst into tears when he saw the legs. He is extremely happy and clinically very stable.” He added that the patient “will soon leave” the intensive care unit.

However, he warned that it is still too soon to say what the long term outcome will be. “This is the first time in the world that this kind of surgery has been carried out, and it is advisable to be prudent and wait to see the results,” said Dr Cavadas.

He expects the patient to be able to walk with the aid of crutches in six or seven months.

“We expect to start to move the knees in three weeks, first passively and then actively,” said Dr Cavadas. “In two months he should be able to walk in a pool,” he explained, and in three months he should be able to bear his weight. “It is realistic to think that, in six or seven months, he could be walking.”

However, it will be a year before Dr Cavadas will be able to evaluate fully the results of the operation and decide whether it can be repeated on other patients.

Time was of the essence during the operation because of the legs’ large muscular volume, which is very sensitive to a shortage of blood, said Dr Cavadas. The left limb was transplanted one hour and a half after the right one.

The patient’s right leg had been amputated in the middle of the femur and the left one in the distal third of the femur. “His chances of walking were zero,” Dr Cavadas said.

Dr Cavadas performed the first and second double forearm and hand transplantations in Spain in 2006 and 2007, the first double complete arms transplantation in Spain (and the second in the world) in 2008, and the first face transplantation in the world that included a jaw and a tongue in 2009.

Notes

Cite this as: BMJ 2011;343:d4541