Lee led three of those earlier operations when he worked at the University of Pittsburgh, including the only above-elbow transplant that had been done at the time, in 2010.
Marrocco’s “was the most complicated one” so far, Lee said in an interview Monday. It will take more than a year to know how fully Marrocco will be able to use the new arms.
“The maximum speed is an inch a month for nerve regeneration,” he explained. “We’re easily looking at a couple years” until the full extent of recovery is known.
While at Pittsburgh, Lee pioneered the immune-suppression approach used for Marrocco. The surgeon led hand-transplant operations on five patients, giving them marrow from their donors in addition to the new limbs. All five recipients have done well, and four have been able to take just one anti-rejection drug instead of combination treatments most transplant patients receive.
Minimizing anti-rejection drugs is important because they have side effects and raise the risk of cancer over the long term. Those risks have limited the willingness of surgeons and patients to do more hand, arm and even face transplants.
Lee has received funding for his work from AFIRM, the Armed Forces Institute of Regenerative Medicine, a cooperative research network of top hospitals and universities around the country that the government formed about five years ago. With government money, he and several other plastic surgeons around the country are preparing to do more face transplants, possibly using the new immune-suppression approach.
Marrocco expects to spend three to four months at Hopkins, then return to a military hospital to continue physical therapy, his father said. Before the operation, he had been fitted with prosthetic legs and had learned to walk on his own.
He had been living with his older brother in a specially equipped home on New York’s Staten Island that had been built with the help of several charities. Shortly after moving in, he said it was “a relief to not have to rely on other people so much.”
The home was heavily damaged by Superstorm Sandy last fall.
Despite being in a lot of pain for some time after the operation, Marrocco showed a sense of humor, his father said. He had a hoarse voice from the tube that was in his throat during the long surgery and decided he sounded like Al Pacino. He soon started doing movie lines.
“He was making the nurses laugh,” Alex Marrocco said.
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Associated Press Writer Stephanie Nano in New York contributed to this report.
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