The UK’s first double hand transplant operation has taken place at Leeds General Infirmary and the patient says his new hands look “tremendous”. Chris King, from Doncaster, lost both his hands, apart from the thumbs, in an accident involving a metal pressing machine at work three years ago. The 57-year-old received two new hands from a donor and says he already has some movement in them. Prof Simon Kay led the operation at the UK’s Centre for Hand Transplants.
Mr King is the second person to have a hand transplant at Leeds, but the first to have both hands replaced. He said, “I couldn’t wish for anything better. It’s better than a lottery win because you feel whole again.” Mr King said the operation, which took place in the past few days, appeared to have been a complete success. “They look absolutely tremendous,” he said. Mark Cahill, who’s a bar owner, was the first person to get a hand transplant four years ago in 2012, performed by Professor Simon Kay, the same doctor who performed surgery of Mr Kay. Details of exactly when the surgery was performed remains a secret and the identity of the donor hasn’t been revealed, for privacy reasons, but it was conducted in the last 10 days.
How the surgery was performed was nothing short of a scientific miracle. The surgery took two days to complete and involved attaching the bones in the arms to those in the new hands using rigid titanium plates and screws. Next a dozen tendons and muscles were reconnected. Surgical microscopes were used for the process of connecting eight microscopic blood vessels, to ensure manageable blood supply. Three major nerves were then reattached, followed by large and small veins. Once ample blood supply was circulating through the arm, remaining muscles, tendons and nerves were connected and the skin was sealed.
Mr King, from Rossington, South Yorkshire, said the operation appears to have been a complete success. ‘They’re my hands,’ he said. ‘They really are my hands. My blood’s going through them. ‘It was just like the hands were made-to-measure. They absolutely fit. And it’s actually opened a memory as I could never remember what my hands looked like after the accident, because that part of my brain shut down.’ Mr King also recalled how he spent three years getting used to having no hands and resigned himself to living an adapted life. Mr King remembers the accident clearly but said that it was pain free.
Around 80 hand transplants have been performed worldwide, offering patients the chance to regain the sensation of touch and carry on living their lives normally. After successful operations, with time and thorough rehabilitation procedures, the donor hand will regain most of its strength and dexterity. It will even feel warm to touch and heal itself when injured, but the operation is a long and complex one. During the six to 12-hour procedure, teams of surgeons work to remove the donor hand while separate teams work on the recipient. Bones are joined with titanium plates and screws. Just as with a typical broken bone, they should eventually heal together, but the plates remain in place to ensure stability.
A single hand transplant costs around £50,000 ($75,000) with a further £2,000 ($3,000) to £3,000 ($4,500) a year in rehabilitation and drug costs in the UK. Eligible patients have typically lost one or both hands, mostly below the elbow. In assessing eligibility, the main focus is on matching blood group for immune acceptability, skin tone and size of the hand. There is currently no option to choose to donate limbs on the NHS Organ Donation Register, so specific permission is sought from the families of potential donors after their death. Due to the special matching criteria and the technically complex nature of the procedure, patients will also be carefully screened for psychological and physical suitability. Around 70% return to work and 75% report an increased quality of life.
Mr Kay is hoping that the success of this surgery will prompt more individuals to come forward with donations and be more willing to the idea of donating hands as they are open to donating other organs such as heart, liver or kidneys. Simon Kay said Mr King had been evaluated for two years before a decision was taken to add him to the list of people suitable for transplant, and for the surgery to work properly the patient has to be psychologically ready for adapting the change, treatment and post-surgery rehabilitation exercises and medications.
There is a lot of innovation coming out of the world of prosthetics in recent years, with DARPA’s mind controlled bionic arm, which seems straight out of a sci-fi movie. With successful surgeries, such as that of Mr King’s, we can expect only greater things.