Patient gets both arms transplanted in Chennai

Chennai: In a first-of-its-kind in Tamilnadu, Stanley Medical College and Hospital created history by doing double-hand transplantation last year. Doctors of the institution elaborate on the need to donate hands, though it need not be life-saving but can significantly impact the patient’s life.

The hospital acquired the licence to conduct hand transplantation programme in 2011, however, it was only in 2018 (7 February) that they were able to perform the first hand grafting.

The patient, Narayanaswamy, hailing from Dindigul, lost both his hands due to electrocution in 2015, In 2018, the family of a person declared brain dead willingly donated the limbs for the surgery.

Explaining about the surgical procedure, the hospital’s plastic surgery department head, Dr Rama Devi, said, “The hands were procured from a brain dead person last year and was transplanted to the in-patient, Narayanaswamy. Both the donor and recipient underwent tendon, nerve and artery dissection following which the hand was fixed. He was put on immunotherapy and physiotherapy and occupational therapy was done.’ Since he was immune-suppressed, he was unable to travel back and forth to his native place and hospital. “As a foreign body would be fixed, he had to be under immunotherapy to ensure his immunity is suppressed. If not, chances of rejection was more,” said the doctor.

Though there was no requirement for the surgeons to utilise any new instruments, they were worried about the hands getting rejected.

“The hand has to be vascularised and be compatible with the patient’s hand and we constantly monitored by taking biopsies. The rejection can be identified with symptoms like blood clot, skin reaction, et al,” explained Dr Rama.

However, the team of surgeons, led by the head, said the patient’s physiology and drugs administered cooperated to make the surgery a success.

The head stated that a majority of the donors do not come forward to donate their hands due to the religious rituals they perform after the death of the person. She further noted that there are a total of 110 patients registered with the hospital for single/double arm transplantation.

“To ensure the religious procedure was not affected, we fixed a prosthetic hand and the deceased donor’s family readily accepted to donate,” said the doctor.

Considered as the Centre of Excellence in performing hand transplantation, the hospital got the licence due to the availability of state-of-the-art facilities and also because of the helping hands extended by allied departments.

About the conditions required for the surgery, she stated, “The hands have to be transplanted within six hours and should be stored in histidine-tryptophan-ketoglutarate (HTK) solution.”

“Just like any other organ, hands should also be considered for donation, for, it could change the quality of life of a person who has lost the limb,” the doctor advised.

Narayanaswamy was discharged from hospital on Monday and received the appointment order from Chief Minister Edappadi K Palaniswami to work as a ward supervisor in a government hospital in Dindigul.

 

Bhavani Prabhakar