DOD Program Gives New Hope to Double Arm Transplant Patient

By Donna Miles
American Forces Press Service

WASHINGTON, Jan. 30, 2013 – As a wounded warrior who lost all four limbs in Iraq shared news of his successful double-arm transplant yesterday, officials at the Armed Forces Institute of Regenerative Medicine, which funded the research making it possible, say the investment will continue to bear fruit in giving new hope to wounded warriors.

A surgical team performs a double-arm transplant on Army Spc. Brendan Marrocco at Johns Hopkins Hospital in Baltimore on Dec. 18, 2012. Marrocco lost all four limbs to an explosively formed projectile in Iraq in 2009. The Armed Forces Institute of Regenerative Medicine funded research to advance the techniques that made the surgery possible. Photo courtesy of Johns Hopkins Hospital   (Click photo for screen-resolution image);high-resolution image available.

Army Spc. Brendan Marrocco appeared yesterday with his medical team, led by Dr. W.P. Andrew Lee, chair of Johns Hopkins Hospital’s plastic and reconstructive surgery department, to announce the successful Dec. 18 double transplant at the Baltimore hospital.

“I really don’t know what to say, because it is such a big thing for my life,” 26-year-old Marrocco told reporters as he demonstrated his ability to move his new left arm. His right arm has limited movement, but Marrocco said he’s hoping to get more soon.

Standing proudly alongside other members of the surgical team was one of his surgeons, Navy Lt. Cmdr. (Dr.) Patrick L. Basile of Walter Reed National Military Medical Center in Bethesda, Md. Basile is assistant chief and director of microsurgery and supervisor for rotating medical students at Walter Reed’s plastic and reconstructive surgery department.

Marrocco, who enlisted in the Army in January 2008, deployed to Iraq nine months later with the 25th Infantry Division’s 3rd Brigade, Alpha Company, 2nd Battalion, 27th Regiment. He and his fellow soldiers had completed a night mission and were returning to Forward Operating Base Summerall on April 12, 2009, when their armored vehicle has hit by an explosively formed projectile -- a roadside bomb designed specifically to pierce armor.

The explosion, which severed Marrocco’s carotid artery and severed all of his limbs, also killed one soldier and wounded another.

Quickly medevaced through Iraq to Landstuhl Regional Medical Center in Germany and on to Walter Reed, Marrocco became one of the first quadruple amputees of the conflict to survive his wounds.

He had been wearing prosthetic limbs before the 13-hour surgery, the first of its kind at Johns Hopkins and only the seventh in the United States. His rehabilitation will continue for years, his surgical team explained, as his nerves slowly regenerate – one inch per month – and he gains the ability to use and control the arms and hands.

“I feel like I got a second chance to start over after I got hurt,” Marrocco told reporters yesterday. “If feels amazing. It’s something I was waiting for for a long time.”

Excitement about the successful transplant, and its implications for other wounded warriors, rippled through the U.S. Army Medical Research and Materiel Command at Fort Detrick, Md., home of the Armed Forces Institute of Regenerative Medicine. The Defense Department launched AFIRM in 2008 to advance research to treat wounded warriors suffering traumatic injuries, explained Army Col. (Dr.) John Scherer, director of the clinical and rehabilitative medicine research program.

One of the goals was to promote transplant procedures that were being conducted overseas, but typically not in the United States, he said. “We wanted to move the scientific field forward to make this an option, not only for wounded service members, but for anyone who may benefit from such a surgery,” Scherer said.
Five years after AFIRM was established, Scherer said, he’s excited to see that effort pay off in ways that can transform people’s lives.

“This goes to the commitment we have to always do our best to do whatever we can to improve the care they get,” he said. “This is pushing the boundaries of clinical medicine to improve on that care,” he added, particularly when compared with options available just a few years ago.

AFIRM stands as a testament to America’s pledge to stand by its wounded warriors, Scherer said.
“It is our duty to do whatever we can to repair these very severe injuries, to push the boundaries of medicine and to say, ‘What we are doing currently is not good enough until we can actually restore the function of the tissue of the hand or arm that was lost,’” he said. “That is our main goal: to make that individual whole again and to do whatever we can, medically, to get there.”

AFIRM is managed and funded through the Army Medical Research and Materiel Command, with additional funding from the Navy’s Office of Naval Research, the Air Force Surgeon General’s Office; the Department of Defense Office of Health Affairs; National Institutes of Health and the Veterans Affairs Department.

Their initial $100 million investment, spread over five years, has nearly tripled with local public and private matching funds, Scherer said.