Groundbreaking First-of-Its-Kind Elbow Transplant Gives New Hope to Trauma Patients
In April 2016, UCSF Health surgeons achieved a medical milestone by performing the world’s first same-patient elbow transplant, a revolutionary procedure that experts believe could change the future of trauma care, veteran rehabilitation, and complex joint reconstruction.
The operation was performed on 37-year-old Reginald Cook, whose life had been dramatically altered by a devastating car accident years earlier. According to UCSF orthopedic surgeon Dr. Lisa Lattanza, the surgery’s uniqueness comes from one extraordinary detail:
“The donor elbow came from the same patient – a mirror-image elbow. This is truly the first procedure of its kind.”
A Medical Breakthrough Built on Collaboration
The complex surgery lasted 12 hours and required a highly specialized team:
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5 surgeons
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2 orthopedic upper-extremity experts
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3 plastic and microvascular surgeons
Working simultaneously on both of Cook’s arms, the team meticulously removed and reattached bones, muscles, nerves, blood vessels, and skin.
“This surgery was like ballet,” Dr. Lattanza said. “Every surgeon knew their role and executed it flawlessly.”
A Life Transformed by Tragedy
Cook’s medical challenges began in 2009 after a horrific car accident left him in a coma for months. He suffered multiple severe injuries, including:
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Traumatic brain injury
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Broken neck bones
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Paralysis in both legs
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Complete detachment of the brachial plexus in his left arm
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A shattered right elbow that never regained function
Despite several reconstructive surgeries, Cook ended up with no functioning elbow in his right arm, which limited him to minimal hand movement. His left arm, lacking nerve connections, was completely nonfunctional. He depended on his sister and a home nurse for nearly everything.
“Reginald had effectively lost the use of both arms,” explained his Texas-based orthopedic surgeon, Dr. Eric Sides. “His right arm was stuck at a 90-degree angle, and his left arm didn’t work at all.”
Designing a Surgery That Had Never Been Done
Desperate for independence, Cook asked his doctors whether an elbow transplant was even possible. Dr. Sides contacted Dr. Lattanza—an old colleague—and together they began exploring the unprecedented idea.
In November 2015, Cook traveled to San Francisco to meet with the UCSF team. The surgery carried serious risks, including the possibility of losing the remaining movement in his right hand.
Over the next several months, Dr. Lattanza worked with global experts to design a procedure that would involve:
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Removing Cook’s left arm above the elbow
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Transplanting the left elbow to his right arm
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Reconstructing all essential nerves, vessels, and muscles
To aid in planning, the team used advanced 3D modeling software from Belgian company Materialise.
Even with extensive preparation, the surgical team had to adapt mid-procedure to unexpected changes in Cook’s anatomy.
But by the end, the results were remarkable.
“The bones aligned beautifully, the joint is functioning, and the tissue flap is alive,” Dr. Lattanza said. “Most importantly, Reginald’s hand movement remained intact.”
Within one month, Cook could lift his hand to his face — a movement he hadn't been able to perform in years.
A New Chance at Independence
After the surgery, Cook remained in San Francisco for close monitoring.
“I’m starting to feel touch and sensation again,” he shared, hopeful and emotional.
Dr. Sides believes that with ongoing physical therapy, Cook could regain the ability to dress and feed himself — and even potentially walk with a cane again.
His left arm, now removed, provides a suitable foundation for a future prosthetic limb.
For Cook, the surgery represents more than just medical progress — it’s a path back to living.
“I can’t wait to be independent again,” he said. “And the first thing I want is to give my 14-year-old daughter the biggest hug. This surgery changed my life.”
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