He can wiggle fingers of his transplanted hands

The nation’s first double-hand transplant recipient has a simple goal: holding — and feeling — his wife’s and daughter’s hands.

Jeff Kepner wiggled the fingers he received on May 4 for TODAY’s Erin Burnett Thursday on TODAY. It wasn’t much — just the tiniest of movements — and Kepner is up to a year away from being able to feel anything in those fingers. But it was proof that the transplant is taking and that, in time, Kepner will have full use of his new hands.

His 13-year-old daughter, Jordan, the last of three children still at the Kepners’ Augusta, Ga., home, can’t wait. You might say she’s even hungering for it.

“One of the first things she said is, ‘Oh boy, you can cook again!’ ” said the 57-year-old retired Air Force educational planner, who once loved to cook.

But returning to the kitchen runs third on his list of things he wants to do when he finally gains sensation and fuller movement in his new hands: “The first thing I want to do is hold my wife’s hand, hold my daughter’s hand and cook again. It sounds silly, but those are the things I want to get back to.”

He also looks forward to taking a shower by himself without having to get his wife to help him, and to be able to dress himself and do things around the house and be fully independent.

“I’m just hoping and praying for independence for Jeff again — not having to rely on me,” Valarie Kepner told Burnett.

New procedure
Kepner lost his hands in 1999 after contracting a virulent strep infection that quickly spread through his entire body. Sepsis set in both his lower legs and hands, and doctors ultimately had to amputate both legs below the knee and both arms below the elbow.

The ex-airman adjusted to life on prosthetic legs and basic prosthetic arms that ended in hooks. He was able to drive and hold down a job at Borders, and had become accustomed to life and his ability to function.

Video   Mother hopes for hand transplant Oct. 28: Sarah Mues lost her hands to a rare infection as a teenager. It was seeing her on TODAY that prompted Valarie Hepner to look into the possibility of a double hand transplant for her husband Jeff. Today show

It was Valarie who first thought of a transplant. She was inspired last fall when she saw a story on TODAY about Sarah Mues, a mother of two who had lost both her hands to a bacterial infection and was being screened by Dr. W.P. Andrew Lee and the University of Pittsburgh Medical School (UPMC) as the center’s first candidate for a double hand transplant.

Valarie did her research and contacted the center and Dr. Lee. Then she had to talk her husband into considering leaving his comfort zone.

Lee, who spoke to Burnett from Pittsburgh along with the Kepners, said that one of the complications holding back limb transplants was the number of anti-rejection drugs required. The drugs would prevent rejection, but also damaged other body systems — not a good trade-off.

UPMC hit on a new procedure: infusing the recipient after the transplant with marrow cells harvested from the donor. The procedure seems to prime the body to be more receptive to the foreign tissue, and has allowed Lee to administer just one anti-rejection drug to Kepner, instead of three.

A hand transplant is a complex surgery with many connections. Jeff Kepner’s is the first double hand transplant in the U.S.

Lee is clearly hopeful, but he cautioned that it is all experimental. “It is too early to tell if our protocol is a success,” he said.

Feelings ahead
The doctor explained that nerves regenerate at the rate of about an inch a month, so Kepner’s own nerves have extended just a couple of inches down his new forearms and are working their way to his hands. In nine to 12 months, Lee said, Kepner should begin to feel things with his fingers. In two years, his new hands should be as fully functional as they can be.

Eight double hand transplants have been performed abroad, especially in France, where the world’s first face transplant was also performed. Until May 4, when Kepner received his new hands and forearms from a 23-year-old donor during a nine-hour operation at UPMC, all hand transplants in the United States had involved just one hand. Five have been performed at the Jewish Hospital Heart and Lung Center of Louisville, Ky., which was the only hospital doing the procedure until UPMC began its program under the direction of Dr. Lee.

Lee performed a single hand transplant, the center’s first, seven weeks earlier on Josh Maloney, a soldier who lost his hand in training. The soldier and the retired Air Force man are now rehabbing together.

Jeff Kepner does not have any sensation in his new hands yet — but he can wiggle his fingers.

In addition to training his new hands, Kepner also has to learn again how to walk on new prosthetic legs; he had previously undergone double hip replacements.

The Kepners have been in touch with the family of the young man who donated his hands. The man left behind a 15-month-old child, and the Kepners are deeply grateful to him and deeply sympathetic to his family.

Lee said that the donor family’s act should make people think beyond just declaring themselves organ donors. At some point, leg transplants will also be possible.

“People should think of other body parts, like arms or face,” Lee said. “Jeff is an example of how organ donation can change his life and his family’s life.”

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