Nerve graft recipient in 2014 Rose Parade

ALACHUA – Edward Bonfiglio was on a routine foot patrol in Afghanistan when he was ambushed. A bullet tore through his left leg, rendering it lifeless below the knee. That didn’t last, thanks to a regenerative medicine company in Alachua.

Alachua-based biotech company, AxoGen, located at the Sid Martin Incubator, recently announced that Navy Corpsman Edward Bonfiglio, a patient who regained the use of his limbs thanks to a nerve graft from Axogen, has been selected by the American Association of Tissue Banks (AATB) to represent tissue recipients on the “Donate Life” float in the 2014 Rose Parade.

Since 2005, the AATB has sponsored the Donate Life Rose Parade float, which serves as a memorial to organ and tissue donors, according to the website. The theme of the 2014 float, “Light Up the World,” supports the organization’s mission of saving and enhancing lives through the gift of organ and tissue donation. The 125^th Rose Parade, which features floats covered in flowers, will take place Jan. 1, 2014, 8 a.m. in Pasadena, Calif.

When he was shot, an injury to his sciatic nerve took away all function and feeling below his knee. Back in the United States, surgeons at Walter Reed National Military Medical Center in Washington, D.C., presented Bonfiglio with surgical repair options that included amputation of his left leg or repair of the severed peripheral nerve using Axogen’s nerve graft, with the goal of restoring function. Bonfiglio chose the nerve graft and today is able to walk and jog, and is currently training for the Paralympics.

“AxoGen is delighted that Edward Bonfiglio has been chosen by AATB to represent tissue recipients in the Rose Parade,” said Karen Zadarej, CEO of Axogen. “He has bravely served our country, is an advocate for tissue donation and an inspiration to patients with peripheral nerve injuries.  It is an honor to have provided the processed nerve allograft that contributed to saving his leg.” 

AxoGen’s website describes the difference between processed nerve allografts, which they pioneered, and autografts, which have been the gold standard for repairing peripheral nerves in the past.

Allografts are taken from human cadavers and processed to remove cellular debris by AxoGen. The process sterilizes the tissue and creates a nerve the body will not reject. Therefore, no drugs are required to prevent the body’s immune system from attacking it.

The autograft procedure removes nerves from another part of the patient’s body for reuse at the injury site. Since tissue is their own, the body won’t reject it. However, an autograft procedure requires two surgeries and can create a second site where tissue may become infected. Another concern is that the nerve removal site will generally lack feeling and scarring can also occur. Nerve grafts taken directly from a patient are usually removed from the leg or foot.

Another benefit of the allograft procedure is that surgeons can obtain a variety of sizes up to seven centimeters. The nerves are kept frozen until needed for surgery. A recent study found that allografts up to 5 centimeters produced results similar to autografts and patients’ nerves re-grow at a rate of roughly an inch a month.

"Allograft has not been done in enough patients to say that it's the same as autografts, but there are advantages if it ends up being equal," said Dr. Ed Akelman, an orthopedic hand surgeon at Rhode Island Hospital and chairman of the council on education at the American Academy of Orthopedic Surgeons.

Akelman said he has used the allografts and called them promising, but is waiting to see the results of more surgeries before switching allegiances from autografts.

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