Transplant Biology at a Crossroads

Feature M att Scott allows that he might not have been thinking too clearly that night in 1985 when the accident happened. After all, it was 2 A.M. when he and his friends returned home from a night of indulging in seasonal cheer, a few days before Christmas. That's when someone thought it might be fun to blow up the old firecracker that had been sitting around the house since midsummer. " I happened to be the one to pick it up, " recalls Scott, then 24 and a paramedic. " I smoked at the time, and I was fooling around with my cigarette, touching the fuse to the tip of my cigarette, never expecting it to light. But it ignited pretty quickly, and burned even more quickly, " he says. His friend screamed at him to throw it away. " But I just took two steps away from him into the kitchen, and it exploded. " The radial artery in Scott's left arm was severed, splattering the kitchen wall with blood. Most of his left hand was gone. He clamped down on the injured limb with his other hand, thinking, " My career is over. My life is over. I can't believe I did this. " Scott and his surgeons decided that what remained of his left hand was not worth saving, so Scott agreed to amputation and was fitted with a prosthesis. As it turned out, neither his career nor his life was over; Scott remained a field paramedic for several years and adapted to the prosthesis. He married and had two sons. But eventually, he came to loathe the artificial hand. " It was a good prosthesis, " he says, " but it was cumbersome, it was uncomfortable, and it wasn't flesh and blood. It became odious to me. " When he read more than 10 years after his injury about a group of surgeons at Jewish Hospital in Louisville, Kentucky, who were planning to conduct a hand transplant despite widespread concern about the risks, Scott was intrigued and contacted the group. He fit the criteria the surgeons were looking for: he had experienced the loss of his limb some time ago and although he learned to live with the prosthesis, his desire for a flesh-and-blood replacement was strong enough that he was willing to take some significant risks. In order to obtain a hand transplant from …