As a surgeon at Boston Children's Hospital, Dr. Amir Taghinia has seen things that would crush the souls of most mortals.
But to help kids with one particular affliction, he and his colleagues have launched an ambitious project — to provide transplants for children who have lost both hands or both arms. Children's created the world's first hand transplant program for youngsters last year, after the hospital's ethics committee spent two years reviewing the idea.
It's a difficult undertaking for many reasons, and an actual transplant may still be years away, Taghinia said. But he's willing to wait.
"I've seen patients lose their hands and their legs. Unfortunately too many,'' Taghinia said. What he'd most like to do is restore them to their full healthy state. But if that's not possible, he said, a transplant may be the next best thing.
"In the right patient, I think it can make a huge difference in someone's quality of life,'' Taghinia said.
Hand or arm transplants for children are a tricky business. Taghinia's group is targeting kids who are at least 10 years old and has already screened many candidates. But there have been no surgeries yet.
"You really want a patient who has good family support, who is psychologically fit so they can potentially withstand the complications that may arise from having a transplant,'' Taghinia said. And importantly, "They completely understand the risks that are involved.''
That's partly why the kids have to be at least 10, he said. They have to want the surgery themselves and to fully comprehend the choice they are making. That includes being willing to take medications to suppress the immune system and endure the side effects, potentially for life, so that the body won't reject the new limbs.
Then there's the difficulty of finding donors. Happily, not many children die. So sourcing donors is far more difficult than with adults donating organs, not least because the donor's size must match the recipient's.
"For all these reasons, it's a challenge, and it will require a lot of patience to find the appropriate candidate and find the appropriate donor,'' Taghinia said.
So they're taking it slow, he said.
"We may never do a hand transplant, and that's OK,'' Taghinia said. But, "We would like to do one. And we think we can help the appropriate patient.''