In a surgical first, Philadelphia doctors have transplanted donor hands and forearms onto an 8-year-old boy whose own hands were amputated when he was a toddler.
Zion Harvey told NBC News that the groundbreaking 10-hour operation performed earlier this month at the Children's Hospital of Philadelphia was a dream come true. He can't wait for the day he holds his little sister with his new hands.
“My favorite thing [will be to] wait for her to run into my hands as I pick her up and spin her around,” he said.
His mother, Pattie Ray, was overcome with emotion as she watched her son being wheeled out of the operating room.
“When I saw Zion’s hands for the first time after the operation I just felt like he was being reborn,” she said. “I see my son in the light I haven’t seen him in five years. It was like having a newborn. It was a very joyous moment for me. I was happy for him.”
A 40-member transplant team led by Dr. L. Scott Levin had practiced extensively on cadavers before attempting the operation — a worldwide first — on a child.
“The success of Penn’s first bilateral hand transplant on an adult, performed in 2011, gave us a foundation to adapt the intricate techniques and coordinated plans required to perform this type of complex procedure on a child,” Levin, chairman of the department of orthopedic surgery at Penn Medicine and director of the hand transplantation program at Children's Hospital, said in a statement.
Zion lost his hands and his feet when he was 2 to a life-threatening bacterial infection that also led to a kidney transplant. Because he was already taking immunosuppressant drugs to stop his body from rejecting the kidney, he was a perfect candidate for another type of transplant.
His spirit and resilience didn't hurt, either.
“I have met with him and his mother several times and you would think an 8-year-old would be overwhelmed or bewildered, or unclear as to the pathway we were setting for him,” Levin explained.
“But when I first met him, I said to him, ‘Why do you want hands, Zion?’ And he said ‘cause I want to swing on the monkey bars. That’s a pretty logical answer for an 8-year-old. And a pretty profound statement to me.”
The loss of his hands and feet has not slowed down Zion, who runs on prosthetics, feeds himself and loves playing video games. “He is a child who has accommodated to the cards life has dealt him,” Levin said.
Still, as he was growing up, Zion secretly wished he might one day have a pair of hands.
“I hoped for somebody to ask me do I want a hand transplant and it came true,” he told NBC News.
During the surgery, the donor's hands and forearms were attached by connecting bone, blood vessels, nerves, muscles, tendons and skin.
Levin remembers the moment he saw one of Zion’s new hands pink up with the blood rushing into it.
“That hand was now alive,” he said. “That became, instantly, part of Zion’s circulation, no different than my hand or your hand.”
Surgeons on the team — which also included Dr. Scott Kozin, chief of staff for Shriners Hospitals for Children–Philadelphia, where Zion was first treated — had already participated in hand transplants for adult patients, but pediatric surgery is very different, Levin said.
Not only do 8-year-olds have smaller bones and anatomical structures, they still have a lot of growing to do.
“The issue with children is they have areas of bone called growth plates,” Levin said. “We had to be very careful when we attached the donor hands to Zion that we did not violate or injure the growth plates because we want his hands to grow and lengthen.”
Zion has responded to the surgery just as his doctors thought he would.
“I’ve never seen a tear, never an untoward face, never a complaint,” Levin said. “He’s always positive. And that, in and of itself, is remarkable.”
The surgery may have profound changes on the lives of children who are living without hands, Levin said.
“This is the end of the beginning, not the beginning of the end,” he added. “We’ve made a big step forward with this operation.”