How important are our hands to our body? Just think, you are probably holding the phone or computer you are using to read this article with your hands. If someone loses their hand due to a serious accident, burn, or severe infection, how much does it affect that person's life and mind? So, today we are going to talk about a surgery that gives such a person a hand again, a hand transplant from a donor.
What is a hand transplant?
Simply put, a hand transplant is the surgical replacement of a hand from a deceased donor to a person who has lost a hand or part of a hand for some reason. This is a relatively new and somewhat controversial procedure in medicine. The reason for this is that the risks associated with this surgery are high.
Imagine, when a vital organ like a heart or a kidney is transplanted, it prolongs the patient's life. But a person can live without a hand. But transplanting a hand can dramatically improve that person's quality of life . How wonderful is it to be able to write on your own again, to wave to someone, and to do your own work? Some people who have had this surgery say that it has also had a great impact on their mental health.
What is a bilateral hand transplant?
This involves transplanting two hands from a donor into the patient's left and right hands. This type of surgery can sometimes take surgeons 24 hours or more to complete.
How do you prepare for this surgery?
This is not something that can be decided on a whim. It requires a lot of preparation. If you are willing to undergo this type of surgery, you will first meet with a transplant coordinator. If you meet the necessary qualifications, the transplant team will then examine you to see if you are a good fit.
They will do a complete physical examination, take your medical history, and perform several tests, such as X-rays and blood tests.
In particular, a mental health evaluation is done before this surgery. Because this is something that will be relevant for life. It is essential to have a strong mindset to face the challenges that come after the surgery and a good support system of family and friends to help you.
Once you are determined to be a suitable candidate, you will be placed on a waiting list. Here you will have to wait for a donor hand that matches your blood type, skin color, and age. The time it takes to get there is uncertain. Once a donor is found, the surgery will be performed as soon as possible.
Before surgery, you must follow these steps:
- If you smoke, stop immediately. If necessary, ask for help with this.
- Under the advice of your doctor, change or adjust the dosage of any medications or vitamins you are currently taking.
- Engaging in physical therapy exercises recommended by the doctor.
- Good control of other underlying medical conditions (such as diabetes, high blood pressure).
- Complete abstinence from alcohol or other drugs.
How the surgery is performed
On the day of the surgery, an anesthesiologist will give you anesthesia. So you won't feel any pain, you'll be asleep. The surgical team will prepare the donor hand and the rest of your hand and make the incisions needed to connect them together.
They very delicately connect the following parts:
- Bone: First, the bones are fixed using metal plates and screws.
- Tendons and muscles: Next, we connect these, which help with movement.
- Blood vessels: Connecting these is essential to restart blood circulation.
- Nerves: Connect nerves to restore touch and sensation.
- Skin: Finally, the wound is closed with stitches on the skin surface.
This surgery can take 12 to 24 hours or even longer.
What happens after the surgery?
After surgery, you will be admitted to the intensive care unit (ICU) for observation. You may need to stay in the hospital for about two weeks. During this time, you will have ongoing blood tests and X-rays to monitor your recovery.
You will be given pain medication. The medical team will regularly check the function of your hand. They will ask you to move your fingers. But it may take a while for these things to happen, so don't worry.
The most important thing is that you will have to take immunosuppressants for the rest of your life. These drugs prevent your body from recognizing the new organ as "foreign" and attacking it (rejection). It is extremely important to take these medications exactly as your doctor tells you to, on time.
You also need to do exercises to increase hand function with the help of a physical therapist.
What are the risks and complications of this?
The biggest risk of this surgery is rejection of the transplanted hand . In addition, other complications can occur. Let's look at them in a table.
| Risk type | Possible complications |
|---|---|
| Risks related to surgery | Bleeding, infections, blood clots, loss of the transplanted arm, and very rarely, death. |
| Other complications | Skin discoloration, skin cancer, feeling like the new hand is not yours (psychological rejection). |
| Side effects of immunosuppressants | Fatigue, headaches, high blood pressure, nausea/vomiting, stomach upset, increased risk of infections, and diabetes. |
Rejection of the transplanted hand
What happens is that your immune system sees the new enemy as an invader and tries to destroy it. This can happen in two main ways.
| Type of rejection | Description |
|---|---|
| Acute Rejection | It can occur within a few days of surgery. Symptoms include pain in the hand, swelling, and skin discoloration. This condition can be controlled with medication . The hand will not be lost. |
| Chronic Rejection | This is something that gradually develops months or years after surgery. Here, the body attacks the hand in a way that even medications cannot control. This can lead to the loss of the transplanted hand . |
How long does it take to heal?
The recovery time varies from person to person. It takes several weeks for the surgical wound to heal. It takes about 6-8 weeks for the bones to fuse. With physical therapy, the strength and function of the hand gradually increase. Even simple tasks like grasping something can take about 8 weeks. Studies have shown that it can take up to 5 years for the body to fully adapt to the new hand and for the nerves to grow.
When should you see a doctor?
If you are interested in this type of surgery, talk to your doctor first. He or she can evaluate your condition and refer you to an appropriate specialist.
If you have had surgery, notify your medical team immediately if you develop any of the following symptoms. Time is of the essence to prevent rejection.
- Skin discoloration or a rash
- Severe pain
- Swelling of the hand
- Decreased previous activity
Take-Home Message
- A hand transplant is not a life-saving surgery, but it can greatly improve a person's quality of life and mental well-being .
- This is a very complex surgery, with many risks and complications .
- The most important thing is that after surgery, immunosuppressants must be taken without fail for the rest of your life .
- Strong mental preparation and family support are extremely important to face this surgery.
- If any warning signs (pain, swelling, discoloration) appear, notify your doctor immediately.
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