Allegheny Alumnus Makes History With Skin Transplant

Alexander F. Mericli, M.D., ’05

 

The weight of what he did — the history he helped make — didn’t fully sink in until later, after the patients were safely out of the hospital and recovering.

“Surgery like this is something that happens once in a lifetime,” said Alexander F. Mericli, M.D., ’05.

Mericli, a plastic surgeon and assistant professor in the Department of Plastic Surgery at M.D. Anderson Cancer Center at the University of Texas in Houston, was a member of a surgical team that in June 2017 successfully completed what he described as the largest skin transplant ever reported, in terms of area covered. The surgery on identical twin sisters was 15 hours long, performed in two stages, and required more than a month of planning. Mericli was one of five surgeons involved.

The path to surgery began with a sarcoma, a cancer of the connective tissue, on one sister’s back. The tumor had been treated before at other institutions but had recurred again and again, Mericli said. It was so large that, when removed, surgeons would need to cover the resulting defect with more skin than they could harvest from any other part of the woman’s body. The woman’s sister volunteered to donate hers.

That the organ donor and recipient shared the exact same DNA was a gift.

“The benefit of doing a transplant on a set of identical twins is, regardless of what you’re transplanting, because they’re a 100 percent genetic match, it doesn’t require immunosuppressants. The (recipient’s) body will accept the tissue or organ as if it was its own.”

On the first day of surgeries that would span two days, surgeons removed the tumor and prepared the site for reconstruction, harvesting a long vein as a graft from the woman’s leg and connecting it to blood vessels that run underneath the arm, Mericli said.

On the second day, in two adjacent hospital rooms, one team of surgeons harvested skin from the donor sister. Another team, of which Mericli was part, placed the skin onto the recipient sister and connected the blood vessels on her skin to the blood vessels they had grafted the day before, providing blood to the transplanted skin.

“It’s a procedure that we do pretty commonly for breast reconstruction, (harvest) extra skin and fat from the belly and transfer that to the breast to remake a breast,” Mericli said. “This is throwing a different twist on it. We’re not using it to make a breast but to cover a large area of a lady’s back that didn’t have any skin.”

Mericli said he didn’t celebrate the success of the surgery until both sisters were out of the hospital. They’re doing well, he said.

“It was a great win,” Mericli said, a smile in his voice.

He said he was humbled to be involved in the surgery, and described the sisters as “remarkable women” with a very special relationship.

“The one sister said she didn’t even think twice about it,” Mericli said before praising his colleagues and M.D. Anderson. “It’s great to work at an institution that supports creative ways to solve problems and think outside the box in order to help people.”

After graduating from Allegheny with a bachelor’s degree in biology in 2005, Mericli attended Jefferson Medical College in Philadelphia and went on to study plastic surgery at the University of Virginia and at M.D. Anderson. His Allegheny education is part of his success, he said.

“I write letters to prospective matriculating (Allegheny) students every year and I try to describe why I think Allegheny helped me get to where I am,” he said. “The thing I always say is that the biology degree helps you understand science and the whole scientific method we approach in medicine and research, but the emphasis Allegheny has on liberal arts education emphasizes creativity and draws upon different areas of your mind so you’re not always thinking about math and science. You’re also thinking about English and art. I think that enhances your ability to solve problems creatively.”

Two sisters might attest to that. 

By

Erica Erwin ’02