Hand transplants now a reality

Losing a hand, whether from accident or warfare, has profound psychological as well as physical implications. Now a viable form of hand transplantation is an option for selected amputees after the results of a small clinical trial with long-term follow-up. Normally amputees are offered either a prosthesis or tissue reconstruction, depending on their condition, neither of which is entirely satisfactory.

The trial followed five patients at the Louisville Center over a ten year period who had lost hands due to fireworks accidents, work-related accidents, and loss due to firearms. What is extraordinary to me is that the transplantation procedures occurred from two years to more than 30 years after amputation and since 1964, more than 40 hand transplantations have been performed worldwide, including 12 patients who received transplants of both hands.

Reasonable function does return to the hands and it has been made possible to have such prolonged survival of a transplanted hand because of the drugs that are used in kidney transplant recipients which were then developed for limb transplants. The only downside seems to be that all such transplant patients require lifetime immunosuppression regimes, but the benefits of having a ‘real’ working hand far outweigh that consideration for all the patients who have been treated.