Federal Player of the Week: Advancing miraculous medical techniques for wounded soldiers

While Congress pokes around for budget cuts, few lawmakers want to drop programs that not only save wounded soldiers’ lives, but put their bodies back together again.

One of those initiatives is the Armed Forces Institute of Regenerative Medicine (AFIRM), a Defense Department (DOD) program that advances miraculous medical techniques for the thousands of soldiers wounded in Iraq and Afghanistan.

U.S. Army

Who is Robert Vandre?

POSITION: Manager, Defense Health Program-Enhanced, Department of Defense

RESIDENCE: Middletown, Md.

AGE: 62

EDUCATION: University of California, Los Angeles, B.S. Physics, 1971; M.S. Physics, 1972; and D.D.S. 1977

AWARDS: Three Legion of Merit medals; the Order of Military Medical Merit; 2010 Major Jonathan Letterman Award for Medical Excellence awarded by the National Museum of Civil War Medicine.

HOBBIES: Photography, genealogy

VOLUNTEER WORK: Represents the Church of Jesus Christ of Latter-day Saints on the Maryland Volunteer Organizations Active in Disaster Committee

Started by Ret. Army Col. Robert H. Vandre Jr., AFIRM is a consortium of 200 scientists and 50 academic and private sector partners who are engaged in clinical trials involving hand transplants, regenerated muscles and new skin for patients. Additionally, regenerative medicine technologies are being prepared for human clinical trials.

“It’s incredible the amount of interest it’s generated and the success the program has had through the sheer force of Robert Vandre’s will,” said Col. Russell Coleman, a colleague and the commander of the United States Army Medical Materiel Development Activity at Fort Detrick, Md.

Regenerative medicine is now more important than ever for the military. Enhanced body armor reduces the death rate in battle, but injuries frequently come from blasts instead of bullets. Fighters may survive, but the destructive force of improvised explosive devices ravages the face, neck, head and limbs, causing massive trauma and tissue loss. Survivors then face the challenge of overcoming these injuries that can take years to treat and frequently result in life-long impairment.

“We’ve done a lot to save lives. Now we’ve got to make them worth living,” said Vandre in describing the impact of the innovative program.

The institute began with Vandre’s vision that the burgeoning field of regenerative medicine could dramatically improve the lives of our wounded warriors. But it wasn’t an easy sell initially.

Obtaining buy-in and financial support from the DOD and other government agencies was one obstacle as was getting scientists from different universities to agree to work together. But of all the obstacles, Vandre said, “incredulity was the major one.”

Vandre said he tried to explain to skeptical government officials that doctors could transplant hands and faces, and recipients wouldn’t have to take anti-rejection medicines forever; that enough skin cells could be grown from a postage-stamp-sized piece of healthy skin to spray on patients burned over most of their bodies; and that scientists could construct dissolvable “scaffolding” from bio materials in the shape of a nose, ear or other body part, grow cells on it and sew it onto someone.

“It’s almost a science-fictionesque world,” said Lt. Gen. Eric Schoomaker, the Surgeon General of the Army.

In the end, Vandre convinced the DOD leadership and officials from several other government organizations, and secured $100 million over five years. He stepped down as project director this year, but continues to serve the colonel who replaced him.

AFIRM has leapfrogged past even Vandre’s wildest expectations. In 2009, the institute conducted the first hand transplants ever performed using donor bone marrow. So far, five patients have been successfully treated with this technology.

Scientists have regenerated muscle, tendon, nerve, and vascular tissue by using patient’s own damaged tissue to regenerate and regain normal appearance and function. They also have engineered skin manufactured using human cells to treat serious and extensive burns, and replaced missing segments of bone, nerve, and blood vessels with artificial biomaterials so that the patient’s own stem cells can regenerate lost tissue. These technologies offer hope for complete restoration of limbs without the need for permanent orthopedic prostheses or amputation.

Two consortia make up the institute—one headed by the University of Pittsburgh and the Cleveland Clinic, the other by Wake Forest University and Rutgers, the State University of New Jersey—for a total of 28 institutions.

Vandre said he became aware of the field of regenerative medicine while an Army dentist. After moving into dental research, he developed a hand-held dental X-ray device and later became interested in battlefield trauma and the possibilities for regenerative medicine.

“He began to ask whether it could make some contribution to how we treat and rehabilitate and restore the most grievously wounded of our combatants,” Schoomaker said. “He’s been remarkably successful in a very short time.”

This article was jointly prepared by the Partnership for Public Service, a group seeking to enhance the performance of the federal government, and washingtonpost.com. Go to http://washingtonpost.com/wp-srv/politics/fedpage/players/ to read about other federal workers who are making a difference.

 
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