“Touch is something very innate to humans, without it so many interactions are changed,” states Dr Dinesh Kumar, one of the plastic surgeons who is credited with having taken up the gargantuan task of performing a bilateral hand transplantation surgery. He, along with a team of doctors at Puducherry’s Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), began the procedure at 5 pm on Monday evening and finished at 2.30 am on Tuesday.
This is the second such surgery to be conducted at JIPMER, with the previous one performed about a year back.
“Reconstructive transplant isn’t done for every individual, there are certain conditions we have to consider,” explains Dr Dinesh, an Additional Professor in the Department of Plastic Surgery at JIPMER. “You have to keep in mind that this is not a life-saving procedure. A person can live without their hands. What such a surgery does do is that it enables us to make an individual independent,” he says.
A 31-year-old man from Puducherry had lost both his hands in a work-related accident, who then received the hands of a donor. The donor was a 22-year-old man who met with a road accident in Bengaluru on November 16 that left him in a serious condition. He was taken to Narayana Health City even as health deteriorated, where he succumbed to his injuries two days later. Doctors at the hospital declared him brain dead, following which his family agreed to donate his organs. The hands were transported to JIPMER by preserving them in a chemical solution and wrapped in ice slush.
In addition to his hands, other vital organs of the donor were also harvested and donated to others who needed them. It was reported that seven lives were saved with these organs, including that of a 67-year-old man from Bengaluru who has liver cancer and an 18-year-old girl from Madhya Pradesh who was suffering from dilated cardiomyopathy.
Reconstructive transplant
Hand transplantation falls under a particular type of group of surgeries known as ‘reconstructive transplants.’ These surgeries are taken up for any soft tissues in the body that have a good blood supply. “Some of the surgeries that fall under this include face, uterus, and hand transplants done following burn injuries and other such soft tissue injuries,” says Dr Dinesh.
“One of the major differences between this and other transplants largely has to do with the high number of structures that have to be reattached. In the case of a heart or kidney transplantation, there are a few significant structures which need to be actively reattached, whereas here we have several,” he adds.
Why not a prosthetic?
An alternative method would be to consider prosthetics for someone who has lost a limb, however as the surgeon goes on to say, prosthetics are expensive and require maintenance. “Not to mention that most sensations are returned when we conduct such a transplant, something that wouldn’t be possible with prosthetics,” explains Dr Dinesh.
He emphasises that the main purpose of undertaking such a surgery is to help an individual gain maximum independence, saying, “It’s about the quality of a person’s life and enabling them to perform their tasks without relying on someone else for every single thing.”
The patient is currently in the ICU and well on his way to recovery. Doctors are confident that he will be able to regain functionality of both his upper limbs with time and physiotherapy.