First two bilateral hand transplantations in India (Part 2): Technical details

Abstract

Introduction:This article deals with two patients who underwent bilateral hand transplantation following amputation of both upper limbs at the distal third of the foream.Materials and Methods:The first patient had a history of loss of hands in a train accident , with possiblity of a run over element during the injury. The second patient lost his both hands in a mine blast. The preoperative work up included detailed clinical and psychological evaluation. The donor retrieval was similar in both the cases and the donors were housed in our own instittution. The donor preparation, recipient preparation and the transplant procedure was similar except for the need of primary tendon transfers in the left hand of the first patient.Results:The first patient needed a free flap transfer to cover compromised skin flap on the left hand on the second day. The second hand transplant was uneventful. Both the recipients are now back to their normal daily routines.Conclusions:Hand transplantation is a potentially life altering procedure, but to optimise the results, it is imperative that there is a meticulous planning and diligent execution with utmost importance to the detail coupled with a synchronised team effort.

Vascularized Composite Allotransplantation of the Hand

“…The field of HT is exceptionally dynamic and scientific advancement will inevitably drive changes in eligibility criteria, one past example is the age of eligibility. Historically, most centers placed strict age Akdeniz University Hospital 15,16 Antalya, Turkey 2021 Amrita Institute of Medical Sciences 17,18 Kochi, India 2017 Boston Children's Hospital 19 Boston, MA 2022 Brigham and Women's Hospital [20][21][22][23][24][25][26][27] Boston, United States 2011-2022 Chang Gung Memorial Hospital [28][29][30][31] Children's Hospital of Philadelphia 5,[32][33][34][35][36] Taipei, Taiwan Philadelphia, PA 2016-2020 2016-2022 Clinica Cavadas [37][38][39][40][41] Valencia, Spain 2009, 2011 Duke University [42][43][44][45][46][47][48][49] Durham, USA 2011, 2018, 2021, 2022 Emory University 50,51 Atlanta, United States 2015 Hacettepe University 52 Ankara, Turkey 2014 Harbin Medical University 53 Harbin, China 2016 Hôpital Edouard Herriot 9,[54][55]…”

Towards Starting a Hand Transplant Unit and Achieving Success in a Hand Transplant: The Standard Operating Procedure

“…It includes reading up the peer-researched literature, attending workshops and conferences, being a part of peer groups of fellow transplant surgeons (local/national associations) and gaining information from other centers, online sources, even seeking guidance from national and international leaders in the field (e.g., Iyer et al and Sharma et al, have described their journey of setting up India's first hand transplant unit in a four-part article series). 4 5 Attending cadaveric workshops for harvest and practice of transplant surgery will also add to the training and create additional harvest teams which will be beneficial to all. Presently, the authors regularly conduct these cadaveric courses.…”

The First Successful Combined Full Face and Bilateral Hand Transplant

“…1 To date, the worldwide vascularized composite allotransplantation experience includes 120 hand transplants in 79 recipients (41 bilateral and 38 unilateral) and 47 face transplants, including two facial retransplants. 1–9 Despite encouraging outcomes and growing public acceptance, these procedures have failed to provide a comprehensive reconstructive solution for patients with composite defects concomitantly involving the face and bilateral hands.…”