Jan. 29, 2013 -- A team of surgeons at Johns Hopkins Hospital has performed the hospital's first successful bilateral arm transplant -- giving two new arms to Brendan Marrocco, an Iraq war veteran.
"I feel great. I'm doing a lot better now," said Marrocco, 26, during a news conference Tuesday of his recovery from last month's procedure. "It gives me a lot of hope for the future."
Members of Marrocco's surgical team, led by Dr. W.P. Andrew Lee, provided details today in Baltimore on exactly how the doctors did the rare transplant and prevented Marrocco's body from rejecting the new limbs.
"Six weeks ago today, a team of physicians and nurses helped restore the physical and psychological well-being of Brendan Marrocco, who lost both arms and legs serving our country nearly four years ago," said Lee. "Only six other [U.S. double hand or arm transplant] patients have been successful and Brendan's was the most extensive and complicated."
Marrocco lost his arms and legs when his unit was struck by an explosive fired projectile outside Baghdad.
When asked what his first reaction was after undergoing the 13-hour transplant surgery, Marrocco said, "I love you!"
"I don't really remember my reaction, which is probably a good thing. I'm still alive and that really matters to me," said Marrocco. "I was just happy that the surgery was over and I had arms."
Last September, Brigham and Women's Hospital in Boston announced it would perform the nation's first double arm transplant. Katy Hayes lost both her arms above the elbow and her legs above her knees after a developing a flesh-eating bacteria infection while pregnant with her third child. Today, Hayes is able to speak to audiences and share her story.
Not all arm transplants are successful. In February 2010, a Turkish man who lost all four of his limbs after he was electrocuted in 1998, Sevket Cavdar, received two arms and two legs following a 20-hour operation at Hacettepe University Hospital in Ankara, Turkey. But doctors eventually had to amputate all four of the transplanted limbs because of "metabolic complications," according to a statement from the hospital.
Marrocco received the arm transplants and bone marrow from a deceased donor -- a method shown to prevent rejection and reduce the need for anti-rejection drugs that can lead to organ damage and infection. His transplants required the connection of bones, blood vessels, muscles, tendons, nerves as well as skin on both arms resulting in "the most extensive and complicated limb transplant procedure to be performed in the U.S.," according to a statement from Johns Hopkins Hospital.
During a news conference today, Marrocco was asked what he'd say to his donor if he could have had the chance to meet him.
"I want to say 'Thank you.' He's the reason I'm alive," Marrocco said. "I wasn't the only one looking forward to it [the transplant]. Everyone in my family was definitely excited. It doesn't only change my life, it also changes theirs, too."
Marrocco's parents, Alex and Michelle Marrocco of Staten Island, N.Y., said the ultimate goal for their son is independence.
"Independence -- that's what we've all worked toward from the very beginning," said his father, "to get him to the point he can live on his own."
Brendan Marrocco's injuries aren't the only blow to hit his family in recent years. The family's home in Staten Island saw its first floor flooded during Superstorm Sandy.
"We've been through a lot worse," Alex Marrocco said.
Amid the damage to their New York home, the couple has been living in Baltimore.
With the new arms, doctors believe Brendan Marrocco's nerves will regenerate at a rate of one inch per month. That means Marrocco will continue to undergo extensive psychical therapy, including daily six-hour sessions of hand therapy for the next two years, first at the John Hopkins Hospital and then at Walter Reed National Military Medical Center.
"Brendan has a full-time job now," said Dr. James Higgins, chief of the Curtis National Hand Center at MedStar Union Memorial Hospital. "He's going to be working very hard. He's already demonstrated that through his therapy at Walter Reed."
Dr. Jamie Shores, the clinical director of hand transplantation at the Johns Hopkins Hospital, was on the team of surgeons that helped with the successful transplant surgery on Dec. 18. Shore said Marrocco's left arm has longer nerves than his right arm.
"It's going to take more than two years to see what his final function is going to be," said Shores. "The good thing about Brendan is that he's an extremely adaptable person. We'll suspect he'll be using his hands for just about everything."
Everything includes swimming and biking, two activities Marrocco is looking to get back into with friends. Driving is another activity at top of his list. A black Dodge Charger currently sits in a family's garage.
"I used to love to drive and it was a lot of fun for me," said Marrocco. "I'm really looking forward to getting back to that and just becoming an athlete again."
As far as other sports, Shores says Marrocco should be able to throw a football.
"I don't think there's much we're going to keep him from doing," said Shores. "He's a young man with a tremendous amount of hope and he's stubborn -- probably in a good way. He's not going to let anyone tell him he can't do something."
Brendan's father agreed.
"He's hard headed. He's stubborn. He likes to do things his way just like any kid would," said his father. "It's those challenges that have gotten him through the ordeal."
The team of surgeons, physicians and nurses volunteered their services to make this transplant possible. The operation was donated by the Department of Defense and the John Hopkins Hospital.
"I never really accepted the fact that I'd have arms. Now that I have them, it's almost like it never happened," said Marrocco. "It's like I went back four years. I'm so happy."