WESTPORT, CT (Reuters Health) - The first living-donor nerve transplant was performed in an 8-month-old boy on Friday by surgeons at Memorial Hermann Children's Hospital in Houston. During the 6- to 8-hour procedure, nerves that had been removed from the legs of the child's mother were transplanted into the infant's left arm.

"This is the first time a nerve transplant has been done with the nerves being taken from a living donor, and we fully expect that the patient will have full use of his arm, wrist and hand," Dr. Scott A. Gruber, head of the transplant team, told Reuters Health on Friday. Previous nerve transplants have been performed using nerves taken from cadavers.

A brachial plexus injury at birth left the infant without sensation or movement in his left shoulder. A week before the transplant the surgical team took the sural nerves from the mother and stored them at 5 degrees centigrade in preservation solution.

"At the same time...we started the child on the immunosuppressive drug FK-506, so that by the time we did the implantation the child would already have therapeutic blood levels of the drug," Dr. Gruber explained. "FK-506 not only prevents rejection but is also a nerve growth factor that speeds the rate of nerve regeneration."

The nerves from the mother will not be functional in and of themselves, he said. They will merely serve as a conduit through which the infant's own nerves can regenerate to their muscle and skin targets--ultimately restoring sensation and motor activity to the entire arm. The expectation is that within 9 to 12 months the infant's nerves will have regenerated sufficiently to reach the muscles.

Dr. Gruber noted that all that current surgical therapy can do, at best, is provide some shoulder stability and possibly some elbow flexion. Wrist or hand function is not a possibility.

He added that the doses of the two immunosuppressive drugs being used are low, and they will be used only for 9 to 12 months, until the nerves regenerate. "So we believe that the chances that this child will develop any serious infection or cancer of the lymph glands are very low."

(From Reuters)