全球首例移植双手儿童实现棒球梦

The first child in the world to undergo a double hand transplant has been able to fulfil his dream of swinging a baseball bat.

A Lancet study reveals that the global first has been classed as a success.

Zion Harvey, who underwent the radical surgery at the age of eight, was able to write, feed and dress himself within 18 months of the procedure, researchers found.

And the American child - who lost his hands and feet at the age of two due to a life-threatening sepsis infection - is continuing to receive daily therapy, which could result in further advances.

Before undergoing the 11 hour operation, the young boy was unable to dress, feed and wash himself. Zion told doctors that his ambition was to one day swing a baseball bat.

After achieving this, the child, from Baltimore in Maryland said: "Here's the piece of my life that was missing. Now it's here, my life is complete."

Within days of the US surgery, which involved four medical teams, working simultaneously, the child was able to move his fingers.

By six months, he could move the transplanted hand muscles, and soon after was able to use scissors and crayons, doctors found.

And 12 months after undergoing surgery, the boy was able to fulfil his dream of swinging a baseball bat, using both hands.

The medical report of the case, published in The Lancet Child and Adolescent Health journal, also details a series of setbacks.

On eight occasions, the transplant began to be rejected, which was managed with immunosuppression drug.

The child also suffered minor infections and impairment to his transplanted kidney, the anonymised report notes.

"Our study shows that hand transplant surgery is possible when carefully managed and supported by a team of surgeons, transplant specialists, occupational therapists, rehabilitation teams, social workers and psychologists," said Dr Sandra Amaral, of the Children's Hospital of Philadelphia.

"18 months after the surgery, the child is more independent and able to complete day-to-day activities.

"He continues to improve as he undergoes daily therapy to increase his hand function, and psychosocial support to help deal with the ongoing demands of his surgery."

The surgery took place in July 2015 at Children's Hospital of Philadelphia in collaboration with Penn Medicine.

Researchers said that caution must be taken when assessing the benefits and harms of such surgery, given the need for immunosuppression medication which carries risk for other conditions.

"While functional outcomes are positive and the boy is benefiting from his transplant, this surgery has been very demanding for this child and his family," Dr Amaral said.

In July last year, Chris King became the first person in the UK to have a double hand transplant in a pioneering operation at Leeds General Infirmary.

全球首个接受双手移植的儿童已经实现了他挥动棒球球棒的梦想。

《柳叶刀》医学杂志的一项研究显示，全球首例儿童双手移植手术成功了。

研究者发现，接受根治性手术的8岁的锡安·哈维在术后18个月内已经能够自己写字、吃饭和穿衣。

来自美国的哈维两岁时因致命的败血症感染不得不截去了双手双脚。他现在每天继续接受康复治疗，预计情况将进一步改善。

在接受11个小时的手术前，哈维不能独自穿衣、吃饭和洗澡。哈维告诉医生他的愿望是有一天能够挥动棒球球棒。

愿望实现后，来自马里兰州巴尔的摩的哈维说：“过去我生命中缺失的那部分找到了，我的生命因此而变得完整。”

经过四个医疗团队的同时努力，手术几天后，哈维能够活动手指了。

医生发现，不到六个月，小男孩已经可以活动移植的手上的肌肉，很快他又能够使用剪刀和蜡笔。

手术12个月后，小男孩实现了用双手挥动棒球球棒的梦想。

发表在《柳叶刀儿童与青少年健康杂志》上的医学报告还详细说明了其中一系列的周折。

移植的双手出现过八次排斥现象，每次都被免疫抑制药物控制住了。

这篇匿名的报告特别提到，哈维的移植肾脏也有轻度感染和损伤。

费城儿童医院的桑德拉·阿马拉尔医生说：“我们的研究表明，在外科医生、移植专科医生、职业治疗师、康复团队、社会工作者和心理学家团队的细心管理和支持下，手部的移植手术是可以完成的。”

“手术的18个月后，哈维更加独立，可以完成日常活动。”

“他现在每天都进行增强手部功能的康复治疗，状况在持续改善。社会心理支持帮助他应对术后不断变化的要求。”

这次手术于2015年7月由费城儿童医院和宾夕法尼亚大学医学院合作开展。

研究人员说，由于术后需使用免疫抑制药物，而该类药物的使用又会有产生其他状况的风险，所以人们在评估此类手术带来的好处和伤害时必须谨慎。

阿马拉尔医生说，“尽管移植双手的功能预后良好，哈维也从中受益，然而哈维和家人也为手术付出了很多。”

去年七月，在利兹总医院的一次开拓性手术中，克里斯·金成为了英国接受双手移植的第一人。