Nerve transplant brings paralysed limbs back to life
THOUSANDS of patients with paralysed limbs could be thrown a lifeline by a revolutionary transplant procedure using nerves from dead donors. Doctors trialling the technique say it has already been proven to restore sensation and mobility to arms within months.
The procedure has so far been carried out on 24 patients with complex nerve injuries at NHS hospitals in Birmingham as part of a pioneering worldwide trial.
Previously, the only option if a nerve was so damaged it could not regrow was to graft nerve tissue taken from elsewhere in the patient’s body, such as the legs.
But grafting requires complex surgery in two areas on the same patient and leaves unsightly scarring, numbness and often pain in the donor site.
The new method involves just a single incision and a better chance of recovery.
One of the first patients to benefit has revealed how the operation has restored his grip.
Peter Smith, 58, underwent the procedure in the spring of this year, having lost the use of his left arm after breaking both arms in a motorcycle smash last year.
The married father-of-two from Birmingham said: ‘This treatment has given me my life back.’
Nerves are essentially bundles of electrically active cells carrying information to and from the brain.
From their roots in or near the spinal cord, they can extend a yard or more to distant parts of the body.
Almost all bodily functions from sensations such as touch and smell, to movement and reflex activities such as breathing and blinking, are controlled by electrical impulses that travel along nerve fibres at up to 250mph.
When a nerve is severed or injured in an accident, it can lead to the loss of feeling or movement, or problems with temperature-regulation, depending on the type of nerve.
Damaged nerves can be segments that are torn, severed or crushed.
Sometimes they can regrow without intervention. However, complex injuries may require removal of the damaged segment and rebuilding the missing part with a nerve graft.
WITH the new procedure, a complete section of nerve cells from a deceased donor is taken and used to ‘bridge’ the two ends of the patient’s severed nerve. Although the transplant does not function as a normal nerve, they act as a scaffold that encourages the patient’s own nerve to grow again, which they can do at a rate of about one millimetre each day.
The first part of the procedure is to treat the donated nerve with enzymes to remove debris from the donor, reducing the risk that the body will reject the graft.
The part is then sterilised and frozen ready for use.
When needed, the donor nerve is cut to the length required to bridge the gap in the severed nerve of the patient. It is inserted via an incision and secured to each severed end with a stitch.
The naturally porous nature of the donor nerve encourages the two ends of the patient’s nerve to grow into it and slowly snake their way towards each other. Surgeons say the breakthrough could help thousands of injured patients.
‘Complex nerve injuries are very common – there are about 300,000 cases a year in Europe involving the hands alone,’ says Dominic Power, consultant hand and peripheral nerve surgeon at the Queen Elizabeth Hospital’s Birmingham Hand Centre, one of the biggest centres in Europe where the new treatment is being used.
‘This new procedure allows us to reconstruct complex nerve injuries where there is nerve loss and restore sensation and movement.
‘It can be done as a day case, there is no general anaesthesia, and surgery is quicker.’
He added: ‘There is also no risk of painful nerve complications from transplanting the patient’s own nerves, and no risk of leg wound complications.’
PETER, who worked as a welder, says he can already feel the nerve growing in his arm. He said: ‘Last year I was riding home on my motorbike when a car pulled into my lane and as a result I hit the crash barrier at 65mph.
‘My arms and all of my ribs were broken. I was put into an induced coma for a month.’
Astonishingly, after several operations Peter recovered. However, he never regained the use of his left arm. ‘The doctors told me there was a 7in gap where the nerve should be,’ he said. ‘So when I was offered this new nerve procedure, I agreed immediately.’
He underwent the transplant operation in May.
He said: ‘I can sense that the nerve is growing. Before, my fingers were hyper-sensitive. If I touched anything, it was like having an electric shock, and I was unable to grip things.
‘Now I can grasp and hold things and I am no longer getting the electric shock sensations.’
He added: ‘It really is amazing what they can do with the nerves, and I feel like it has helped give me my life back.’