YOUR HEALTH: Avoiding an amputation with a transplant

COLUMBUS, Ohio – Modern medicine has allowed medics to save countless lives.   It gives doctors away from the battlefield a greater chance to try new techniques to help wounded warriors recover in ways no one could have expected even a few years ago.

In August 2010 Marine Corporal Jeffrey Cole was exactly one month into his deployment in Afghanistan when he came under enemy attack.

"I knew that from the minute I got wounded I couldn't use my arm from the shoulder down," Cole remembered.

The machine gun fire shredded the muscles and main nerve in his left arm and severed an artery.  Medics saved his life, but told him he`d never regain use of his arm.

Corporal Cole was flown to Walter Reed Medical Center.   After several surgeries, doctors prepared to amputate.  That`s when reconstructive surgeon and fellow soldier, Doctor Ian Valerio, offered an experimental option, a transplant of a large nerve.

"If you think of the nerve as a cable, a wire cable. If someone cuts the cable and cuts a segment of the cable, there's no signal that can generate across the defect," explained Dr. Valerio, a plastic and reconstructive surgeon at Ohio State University's Wexner Medical Center.

Dr. Valerio inserted a seven centimeter section of specially-prepared human tissue called an avance nerve allograft.

"We're basically giving a pathway or highway for nerves to grow back down to re-enervate their targets to get function back," said Dr. Valerio.

The nerves grow back about a millimeter a day. 14-months after surgery, Cole had a sudden breakthrough, reaching for equipment during physical therapy.

"I'm gonna see if I can grab this," he recalled.  "So I reached out and grabbed it and that was the first time.  At the initial stages getting dressed was difficult, trying to button buttons."

"He's still working on it, and every day, hopefully, it'll get better and better," said his girlfriend, Jessica Moore.

Four days a week, Cole still dons a uniform and goes to a Washington, DC job that he loves.

"I'm a park ranger on the National Mall, which is pretty amazing. I'd like to think that I still serve my country, just in a different capacity."

And here's more good news for Jeffrey: although he received a transplanted nerve, he does not have to take anti-rejection drugs because of the way in which the human tissue was processed before it was transplanted.

BACKGROUND: Nerve grafts are used when a patient has a nerve injury resulting in complete loss of muscle function or sensation. A nerve graft is a surgical technique in which a segment of unrelated nerve is used to replace or bridge an injured portion of nerve. The donor nerve serves as a 'track' along which axons (appendages of neurons, which transmit impulses from the spinal cord to the muscle) can grow down to the target area. Grafts are selected from nerves that are considered expendable, or much less important than the function being restored. The nerve allografts are decellularized and act as a biological scaffold for the patient`s own tissue to grow into the transplant and permit axon and nerve regeneration. After surgery, a patient will have some numbness in the region of the donor nerve that will lessen over several years.   (Source: http://nerve.wustl.edu/nd_graft_brachial.php)

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com Marjorie Bekaert Thomas at mthomas@ivanhoe.com.