World first: a double forearm transplant thanks to marina lugworms from the company Hemarina

12 November 2021

Amrita Institute of Medical Sciences (AIMS) in Kochi, India, Becomes the First Hospital in the World to Carry Out Bilateral Upper Limb Transplant using HEMO2life®

HEMO2life® oxygen carrier medical device derived from Arenicola marina lugworm facilitating grafts preservation without delayed graft function opens up new opportunities to complex transplants.

Hemarina, a biotech company based in Brittany and Amrita Institute of Medical Sciences (AIMS) based in Kochi (Kerala) in India, announced that on September 25th 2021, the first double upper limb transplant was performed on a young double amputee patient, using HEMO2life® graft preservation technology based on physiological release of oxygen from Arenicola marina lugworm hemoglobin. For AIMS, it is the 9th double upper limb transplant surgery and the first one to be performed with HEMO2life® medical device. Unlike kidney or liver transplants which are routinely conducted every week, approximately only around 200 hand transplants have been performed worldwide in the last 20 years and double upper limb transplants are extremely rare worldwide mainly due to the difficulty of the surgery which requires many hours of intervention and complex logistics involving a large number of doctors and paramedics.

HEMO2life® is composed of an extracellular hemoglobin extracted from Arenicola marina discovered by a biomimetic approach. Indeed, this lugworm contains human hemoglobins ancestor which were not included in a red blood cell 450 million years ago, since the marine organisms first appeared on earth.

This lugworm is in a position to remain at least 6 hours without breathing thanks to his hemoglobin which fills with oxygen at high tide. It was able to cope with tides phenomenon. High tide / low tide cycle is similar to ischemia-reperfusion in medicine. A graft disconnected from the donor is oxygendeprived can be compared to low tide lugworm living on its oxygen supply. Providing lugworm oxygenrich hemoglobin to the graft helps it getting enough physiological oxygen to be maintained alive, despite being disconnected. This universal oxygen carrier was developed after several years of research carried out by the breton biotech company Hemarina and is the first product clinically efficient in the prevention of ischemia/reperfusion in organ transplant.

This world first bilateral upper limbs transplant using HEMO2life® was unique in many aspects. Indeed, this complex surgery took 14 hours of operating time, involving 10 plastic and reconstructive surgeons, 4 orthopaedic surgeons, 6 anaesthesiologists and 25 supporting staff including many scrub nurses.