Surgeons at the St Petersburg University Clinic transplant a child with his mother’s finger

Before the operation at the St Petersburg University Clinic, the little patient had a long history of treatment: in the early years of his life, he was diagnosed with acute lymphoblastic leukaemia. At the age of three, the boy received a bone marrow transplant from his mother. However, this triggered a graft versus host reaction, in which the transplanted bone marrow and its immune system attack the recipient’s body cells.

This started a process of damage to the skin, joints, mucous membranes, eyes and gastrointestinal organs. Doctors from the Raisa Gorbacheva Memorial Research Institute of Children’s Oncology, Haematology and Transplantation, where the boy was being treated for the underlying disease, managed to achieve remission of the leukaemia and stop the rejection reaction. However, as a result, the patient’s skin was covered with scars, and the fingers of his hands fused together, becoming bent and immobile. 

In order to restore the mobility of the hand, the doctors from the Pirogov Clinic of High Medical Technologies at St Petersburg University — Vladimir Zavarukhin, Head of Trauma Department No 3, and orthopaedic traumatologists Natalia Prokofeva and Anna Firsova — performed several operations. However, a few months later, the child’s depressed immune system was unable to cope with another infection and the boy developed necrosis of the thumb against a background of sepsis. 

In order to save the hand and restore its functionality, without which even the simplest actions are impossible, the University surgeons decided to act in two stages. In the first, they removed dead tissue from the thumb and transplanted a piece of his mother’s skin, because after the transplant, her immune system and her son’s immune system are copies of each other, which significantly reduces the chances of rejection. The donor site took root, and the doctors moved on to the second stage, which involved restoring the thumb. After complications, it had lost the ability to bend and could no longer reach the other fingers of the hand.

In such cases, a complex microsurgery is usually performed — transplanting a toe from the patient’s foot to their hand. However, due to the effects of secondary scleroderma on the boy’s toes, this treatment option was not possible.

The surgeons from St Petersburg University transplanted part of the second toe from the foot of the donor — the patient’s mother. Microsurgical techniques allowed the thinnest of vessels and nerves to be sewn together under a microscope, allowing the finger to take full root. 

According to traumatologist Vladimir Zavarukhin, it is difficult to make any predictions at the moment, as cases with such a coincidence have not been described before. However, at the moment the transplanted finger is the only one in the child with a preserved nail plate and unaffected skin, which allows the doctors to expect the maximum functional effect on the child’s abilities.

St Petersburg University, the oldest university in Russia was founded on 28 January (8 February) 1724. This is the day when Peter the Great issued a decree establishing the University and the Russian Academy of Sciences. Today, St Petersburg University is an internationally recognised centre for education, research and culture. In 2024, St Petersburg University will celebrate its 300th anniversary. 

The plan of events during the celebration of the anniversary of the University was approved at the meeting of the Organising Committee for the celebration of St Petersburg University’s 300th anniversary. The meeting was chaired by Dmitry Chernyshenko, Deputy Prime Minister of the Russian Federation. Among the events are: the naming of a minor planet in honour of St Petersburg University; the issuance of bank cards with a special design; the creation of postage stamps dedicated to the history of the oldest university in Russia; and the branding of the aircraft of the Rossiya Airlines to name just a few. Additionally, the University has launched a website dedicated to the upcoming holiday. The website contains information about outstanding University staff, students, and alumni; scientific achievements; and details of preparations for the anniversary.