DR. ALLAN LEVI PERFORMS THE WORLD'S FIRST NERVE GRAFT USING A PATIENT'S OWN CELLS TO TRY TO REPAIR A SEVERE PERIPHERAL NERVE INJURY
Dr. Allan Levi, director of clinical research at The Miami Project to Cure Paralysis recently performed the world’s first nerve graft using a combination of a patient’s own nerve and her own Schwann cells in an attempt to repair a severely injured sciatic nerve. The FDA approved study took place at the University of Miami/Jackson Memorial Hospital.
The patient, Danielle Press, 26, suffered life-threatening injuries in a boating accident off the coast of Key Biscayne on September 14, 2013. She was rushed to Ryder Trauma Center at the University of Miami/Jackson Memorial Medical Center with several deep, lacerating injuries to her upper leg. Trauma surgeons immediately operated on Danielle, who had lost a lot of blood and nearly died.
Doctors discovered that the sciatic nerve in her left leg, which controls the majority of movement and sensation in the leg, had been completely cut and separated. Danielle, a college graduate who taught English in South Korea, was told that she may never regain any feeling or movement in her leg as a result of the injury.
Repairing the sciatic nerve - the largest nerve in the human body - presents one of the most difficult challenges in nerve surgery, particularly when a significant gap exists, as was the case with Danielle. One of the major limiting factors in the repair of this nerve is the absence or lack of donor nerve material. Even in cases in which a relatively small gap exists, the donor nerves that are located in the lower leg that are harvested for this repair are rapidly depleted. Insufficient autologous nerves are a major obstacle to successful repair strategies for sciatic nerve injuries with large gaps like the one seen in this case.
Dr. Levi, who specializes in the field of spine and peripheral nerve surgery, considered traditional nerve grafting, but felt that Danielle may have a better outcome with alternative treatment options, such as using her own Schwann cells, expanded in number using cell culture techniques. Schwann cells are involved in many important aspects of peripheral nerve biology including the conduction of nervous impulses along axons, nerve development, and regeneration. Dr. Levi and his team are leading an FDA approved Phase 1 clinical trial as part of the University of Miami Miller School of Medicine's Miami Project to Cure Paralysis using a patient’s own Schwann cells for acute spinal cord injuries. Pre-clinical work suggested that the use of Schwann cells could also be beneficial in Danielle's unique case.
Friday - October 10, 2014
Neuroscience Center Seminar Series
LPLC 7th Floor Apex Auditorium
David H. Rowitch, MD, PhD
Department of Pediatrics and Neurological Surgery
Chief of Neonatology
University of California- San Francisco