Emily Fennel, who lost a hand in a car accident five years ago, received a donated hand after a 14.5 hour operation involving a team of 20 at the Ronald Reagan UCLA Medical Center, Los Angeles, last month. She showed off her new hand yesterday, accompanied by the medical staff.

In 2006, Fennel was involved in a rollover car accident, her hand went through the open sun roof and was crushed – it had to be amputated.

Fennel says that getting used to her new hand is a gradual process, but she does feel like its hers, and as each day passes it feels more and more hers. She had been using a prosthetic hand during the last five years, but wanted a proper hand so that she could take care of her daughter better.

During the marathon operation on March 5th, surgeons grafted a hand from a deceased donor and connected tendons, nerves, blood vessels and bones. The deceased donor’s family, from San Diego, consented.

The surgical procedure was done in the following order:

  • Bone fixation
  • Tendon repair
  • Artery repair
  • Nerve repair
  • Vein repair

A hand transplant operation lasts much longer than a typical heart one, which takes from 6 to 8 hours.

Ronald Reagan UCLA Medical Center started its hand transplant program in 2010 – Fennel is their first completed hand transplant – it is the 13th in the country. This is part of a UCLA clinical trial aimed at confirming that already-established surgical techniques in hand transplantation are successful. The medical center is also studying how transplanted hands regain function, as well as assessing a less toxic anti-rejection drug protocol.

Dr. Kodi Azari, chief surgeon, said the operation was a success and now the patient has the long task of learning how to use her new hand. As she has not used a hand for five years, the muscles in that area have become weak and will need to be strengthened.

During yesterday’s press conference Fennel was seen clapping her hands when it came to thank the medical team.

After her car accident Fennel became proficient in using just her left hand, and managed to type 45 words per minute with just one hand, she also tied her shoe laces and drove. She described the prosthesis she used as not very useful and rather bulky.

Although she has no feelings yet in her new hand, she is able to move some fingers. Experts say that it may take a year for the nerves to regenerate.

Fennel has been undergoing intensive rehabilitation over the last four weeks, so that her dexterity and hand strength can improve. Experts say she should be able to return home to Yuba City, near Sacramento, California, next month and resume her rehab there.

Her daughter described mommy’s new hand as “Cool”.

She should eventually gain about 60% of the function her other hand has, doctors said. However, it will never be as strong as the one that got crushed in the car accident. As long as this means she will be able to type faster, catch a ball and widen her current range of functions, that’s fine, Fennel said.

Fennel will have to take immunosuppressant drugs to prevent her body from rejecting the new hand, for the rest of her life. Experts are currently trying to seek out the least toxic way of achieving this. The body’s natural immune system will try to reject and destroy the hand, as it would when identifying a pathogen (organism that causes disease). Immunosuppressant medications can weaken the immune system, making the patient much more susceptible to serious complications from minor infections.

The transplant team say they will map Fennel’s brain at key points during her recovery, observing which parts of her brain light up when she is asked to move parts of her new hand.

To view the UCLAHealth video please click here.

Written by Christian Nordqvist