Hand transplant procedures get a shot in the arm, two city hospitals acquire license

Though a complex process, doctors say it has been accepted as best forms of rehabilitation in people with loss of hands

People who have lost one or both hands now have a new ray of hope as the city now has two hospitals which have acquired hand transplant license. While the civic-run KEM Hospital in Parel received the hand transplant license a few months ago, Global Hospital has received it last week.

In comparison to prosthetics, doctors say, a hand transplant can become like a natural limb with regular rehabilitation. “It is a ray of hope for people who lost their hands in an accident. Like any other organ transplant, in this transplant too, the donor hand is retrieved from a brain dead patient with the relative’s consent. Blood group matching is necessary,” said Dr Vinita Puri.

India’s first hand transplant surgery was conducted last year in Kerala at the Amrita Institute of Medical Sciences and Research Centre. Over the world, around 110 cases of cadaver hand transplant have been documented so far with less than three per cent rejections.

Puri said a hand transplant has been accepted as best forms of rehabilitation in people with loss of hands. “It is a complex surgery involving bones, tissues, muscles and blood vessels. In hand transplant, all the correct tendons, nerves and arteries need to be identified and connected,” said Puri.

Manu TR, then 29, was India’s first hand transplant recipient who was operated upon in January 12, 2016. The second recipient was Captain Abdul Rahim from Afghanistan’s BSF, who had lost both his arms while defusing a bomb near Kabul.

“Hand transplant is a complex procedure requiring highly specialised surgeons, trained in hand and reconstructive microsurgery. The average operating time for single hand transplant is 8 to 10 hours and double hand transplant is 15-18 hours,” said Dr Nilesh G Satbhai, plastic surgeon, Global Hospital.

The procedure

Explaining the hand transplant procedure, Satbhai said pre-operative matching of the donor and recipient is performed to judge the compatibility for transplantation. “Just before the surgery, the recipient is started with immunosuppressive medications, to avoid rejection of the transplanted part. Surgery consists of harvesting the hands from the brain-dead donor. The donor is fitted with an artificial (prosthetic) hand to avoid social and psychological issues related to the visible mutilation. The donor hand is then attached to the recipient stump part by part. Bones are fixed first followed by repair of the major blood vessels, tendons, nerves and the skin”, Satbhai said.

Apart from India, France, US, Germany, UK, Canada, Iran and China have successfully done hand transplants worldwide.