For the first time west of the Rocky Mountains, a successful hand transplant has been performed. Surgeons at Ronald Reagan UCLA Medical Center performed the transplant on a 26 year old mother from Northern California who lost her right hand in a traffic accident nearly five years ago. The procedure took a total of six hours.
Dr. Kodi Azari, surgical director of the UCLA Hand Transplant Program and associate professor of orthopaedic surgery and plastic surgery at the David Geffen School of Medicine at UCLA said:
The transplant was made possible by the family of a deceased donor in San Diego.
The transplant surgery is part of a clinical trial at UCLA intended to confirm that surgical techniques already established in hand transplantation are successful. The trial also aims to study the return of function in transplanted hands and to assess the effectiveness and safety of a less toxic anti-rejection medication protocol.
The operation is carried out in the following order: bone fixation, tendon repair, artery repair, nerve repair, then vein repair. The operation typically lasts 8 to 12 hours. By comparison, a typical heart transplant operation lasts 6 to 8 hours.
The recipient of a hand transplant needs to take immunosuppressive drugs, as the body’s natural immune system will try to reject, or destroy, the hand. These drugs cause the recipient to have a weak immune system and suffer severely even from minor infections.
The first hand transplant to achieve prolonged success was directed by University of Louisville surgeons Drs. Warren Breidenbach and Tsu-Min Tsai in cooperation with the Kleinert Hand Institute and Jewish Hospital in Louisville, Kentucky. The procedure was performed on New Jersey native Matthew Scott on January 24, 1999. Scott had lost his hand in a fireworks accident at age 24.
On May 4, 2009 Jeff Kepner, a 57-year-old Augusta, Georgia, resident, underwent the first double hand transplant in the United States at the University of Pittsburgh Medical Center by a team led by Dr. W.P. Andrew Lee, who also had been performing careful basic research on such transplants for many years.
Dr. Ronald Busuttil, executive chair of the UCLA Department of Surgery, chief of the division of liver and pancreas transplantation, and a groundbreaking transplant surgeon who 27 years ago established the world-renowned UCLA Liver Transplant Program added:
“This surgery is part of the UCLA tradition of excellence in transplantation, and this is clearly a landmark event. We now are the first center in the western United States to be performing composite-tissue transplantation. Everything necessary for this procedure has been aligned perfectly, with outstanding planning and teamwork. It has come together beautifully.”
The transplant team will closely monitor the patient’s progress and how well her body adjusts to the new hand. As part of this, doctors will map her brain at key points in her recovery, observing which parts light up when she is asked to move her fingers or other parts of the new hand.
Non-vital organ transplantation is a new and developing field. Many individuals who have lost hands or other non-vital organs believe that the benefits of the surgery far outweigh the costs and risks.
Source: University of California, Los Angeles Newsroom
Written by Sy Kraft, B.A.