26 year-old Danielle Press arrived at Jackson Memorial Hospital on Saturday, September 14th losing tremendous amounts of blood after a boating accident in which the propeller sliced into her leg, cutting through the sciatic nerve. The sciatic nerve is the largest nerve in the body and regulates most of the movements and sensations in the leg.
Press was close to death following the traumatic injury, and doctors feared she might never regain feeling and movement in her left leg.
“It’s kind of a blur,” Press later said. “I don’t really have much memory of the accident itself.”
Historic Nerve Graft Procedure uses Schwann Cells
Several weeks after the injury, University of Miami and Jackson doctors embarked upon a first-of-its-kind, historic neurologic procedure that could set a new standard in the area of nerve repair. Nerve damage as severe as the damage in Press’ leg often leads to paralysis.
In a late October press conference, UM Hospital officials announced that they had combined Press’ own nerves and Schwann cells, which are crucial to nerve function, to perform a nerve graft to repair the three-inch tear in her sciatic nerve. The experimental surgery was performed two weeks prior in mid-October. The procedure involved harvesting some of Press’ Schwann cells, critical cells in the nerve, and expanding them in a lab. The mature cells were then grafted to the damaged portion of the nerve.
Neurosurgeon Dr. Allan Levi was required to obtain approval from the Food and Drug Administration for the new procedure. When developing this approach, Levi cited research conducted by the Miami Project to Cure Paralysis, a project at UM’s Miller School of Medicine, which has used a patient’s own Schwann cells to treat spinal injuries.
According to the Miami Project, Schwann cells (SC) are a type of cell found throughout the entire peripheral nervous system (PNS). Schwann cells insulate individual nerve fibers (axons), which is necessary for sending appropriate electrical signals throughout the nervous system. Schwann cells are adult cells, not stem cells.
Successful Procedure could set Precedent for Future Nerve Injury Treatments
Dr. Levi explained that two patients have received these cells for spinal cord injuries (SCI), but the technique has never been used to repair a peripheral nerve such as a sciatic nerve. Levi’s team believes that the procedure could maximize nerve regeneration and restoration of function. However Levi was careful to note that years of therapy remain and time will tell if the procedure will help Press gain function of her leg. If successful, the procedure could lay new groundwork for future treatment plans for spinal cord injuries and other cases involving major nerve damage.
“The next steps will be over months and years as those nerves grow back down her leg to see how much recovery she gets,” he said.
Press’ father Charles, Key Biscayne’s police chief, told reporters Levi was convincing in his pitch, and Danielle was eager to try it.
“Danielle felt very strongly that if she can be the one that can alter the course for others, then she was willing to do that,” he said.
“Just to have a chance to do something extraordinary or be part of something bigger than myself was a great feeling,” Press exclaimed.
References:
The Miami Project
Miami Herald
