Nerve Transplant Saves a Soldier’s Arm


COLUMBUS, Ohio. (Ivanhoe Newswire) – For every American man or woman killed in military service, seven are wounded. Recent advancements in battlefield emergency medicine have allowed medics to save countless lives, and new techniques used here at home are helping wounded warriors recover in ways no one could have expected, even a few years ago.

In August 2010 Marine Corporal Jeffrey Cole was exactly one month into his deployment in Afghanistan when he came under enemy attack.

“I knew that from the minute I got wounded, I couldn’t use my arm from the shoulder down,” Cole told Ivanhoe.

The machine gun fire shredded the muscles and main nerve in his left arm and severed an artery. Medics saved his life, but told him he’d never regain use of his arm. Cpl. Cole was flown to Walter Reed Medical Center. After several surgeries, doctors prepared to amputate. That’s when reconstructive surgeon and fellow soldier, Ian Valerio, M.D., at The Ohio State University Wexner Medical Center, offered an experimental option, a transplant of a large nerve.

“If you think of the nerve as a cable, a wire cable. If someone cuts the cable and cuts a segment of the cable, there’s no signal that can generate across the defect,” explained Dr. Valerio. (Read Full Interview)

Dr. Valerio inserted a seven centimeter section of specially-prepared human tissue called an Avance nerve allograft.

“We’re basically giving a pathway or highway for nerves to grow back down to reenervate their targets to get function back,” said Dr. Valerio.

The nerves grow back about a millimeter a day. Fourteen months after surgery, Cole had a sudden breakthrough, reaching for equipment during physical therapy.

Cole said, “I’m gonna see if I can grab this. So I reached out and grabbed it and that was the first time. At the initial stages getting dressed was difficult, trying to button buttons.”

Cole’s girlfriend, Jessica Moore, detailed, “He’s still working on it, and every day, hopefully, it’ll get better and better.”

Four days a week, Cole still dons a uniform and goes to a DC job that he loves.

Cole said, “I’m a park ranger on the National Mall, which is pretty amazing. I’d like to think that I still serve my country, just in a different capacity.”

Although Cole received a transplanted nerve, he does not have to take anti-rejection drugs because of the way in which the human tissue was processed before it was transplanted.

Contributors to this news report include: Cyndy McGrath, Supervising and Field Producer; Milvionne Chery, Assistant Producer; Roque Correa, Editor; Roque Correa and Kirk Manson, Videographer.




REPORT:       MB #4251

BACKGROUND: Nerve grafts are used when a patient has a nerve injury resulting in complete loss of muscle function or sensation. A nerve graft is a surgical technique in which a segment of unrelated nerve is used to replace or bridge an injured portion of nerve. The donor nerve serves as a “track” along which axons (appendages of neurons, which transmit impulses from the spinal cord to the muscle) can grow down to the target area. Grafts are selected from nerves that are considered expendable, or much less important than the function being restored. The nerve allografts are decellularized and act as a biological scaffold for the patient’s own tissue to grow into the transplant and permit axon and nerve regeneration. After surgery, a patient will have some numbness in the region of the donor nerve that will lessen over several years.

TREATMENT: In 2010, Marine Corporal Jeffrey Cole was shot in the arm while on duty. The machine gun shredded his muscles and main nerve, and severed an artery. Some doctors told him he may have to have his arm amputated, but instead, doctors decided to try one of the longest nerve grafts, of nearly three inches. Cole received the surgery at Walter Reed National Military Medical Center, Bethesda, Maryland. Cole was the first upper extremity surgery of this kind, said Dr. Ian Valerio, who performed the surgery at the time. Doctors had performed several similar surgeries prior to Cole’s, but only using 30 mm or 50 mm grafts. Valerio used an Avance graft, or processed human tissue, that can repair severed nerves as it revascularizes and eventually becomes a part of the patient’s own tissue, according to its maker, AxoGen.

AXOGEN: AxoGen Inc. is a global leader in innovative surgical solutions for peripheral nerve injuries. “AxoGen is proud to have provided the solution for Jeffrey’s nerve injury,” stated Karen Zaderej, AxoGen’s President and Chief Executive Officer. Dr. Valerio says many of the advances that were initially used to help wounded servicemen and women are now helping civilians with nerve injury due to trauma and cancer. Dr. Valerio is no longer an active duty serviceman. He has a new position in the Plastic and Reconstructive Surgery Dept. of The Ohio State University Wexner Medical Center, but he continues to serve in the Reserves, and spends two weeks every summer treating soldiers at Walter Reed.



Eileen Scahill



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Doctor Q and A

Read the entire Doctor Q&A for Ian Valerio, M.D.

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