Medical Professionals Online

Complete Hand Transplant Successfully Performed In 19 Hour Operation, Atlanta, Georgia

July 24, 2017

Linda Lu, 21, who lost her left hand from complications from Kawasaki disease when she was one year old, has received a complete hand transplant at Emory University Hospital, Atlanta, Georgia. She is the 14th patient in the United States to undergo such a transplant successfully. Lu said:

"I've already accepted it as my hand since the day I woke up. But just looking at it, sometimes I still can't believe that it's there. . . It kind of feels like magic."

The 19-hour operation involved a team of surgeons who connected tendons, bones, nerves, blood vessels and skin to connect Lu's arm to the hand of a deceased donor (anonymous).

The patient said she now has to undergo extensive physical therapy and rehabilitation to gain function with her new hand. Doctors have told her they doubt she will ever achieve the same level of strength her other hand has. Her fingertips will most likely eventually develop sensation; she will be able to move her fingers as well as her hand. Doctors added she will eventually be able to make a fist, her nails will grow, and she will be able to use her hand to discern temperature.

Lu is studying IT (information technology) and would be pleased if her typing skills could be enhanced now she has two hands.

Head hand-transplant surgeon, Dr. Londa Cendales, said that a hand transplant is different from other organs because it involves several layers. The surgeons have to reconnect bone, followed by the soft tissues, and then graph tendons and nerves have to be applied using a microscope.

A hand transplant, unlike a kidney one, for example, is a visible transplant. The donor hand must match the recipients in many other ways, including size, skin tone and gender. A male donor hand on a female recipient would be unsuitable. Lu and her medical team had been waiting since November for a suitable hand.

As is the case with human transplants, Lu will have to take medications to stop her body from rejecting the new hand.

Lu said she could not believe it when the Emory team called her saying they had a match. Even on the plane from Florida to Atlanta she kept waking up and thinking the whole thing was a dream.

Lu says she has already accepted her new hand as hers. But she still looks at it, amazed that it is there.

When Lu was one year old she had Kawasaki disease. Kawasaki disease is a very rare syndrome that causes high fever, conjunctivitis, reddened lips and the mucous membrane inside the mouth, ulcerative gum disease (gingivitis), swollen neck glands, and a bright red rash that spreads over the feet and hands of young children. The walls of the arteries become inflamed - even the coronary arteries, the ones that supply the heart muscle with essential blood. Kawasaki disease affects the skin, mucous membranes and lymph nodes.

Due to a complication of Kawasaki disease, doctors had to amputate her left hand.

Lu's transplant was funded by a grant from the Department of Defense, and the backing of Senator Saxby Chambliss (R-GA).

The deceased donor's family said they wish to remain anonymous.

Cendales said the next three to six months are crucial, as most of the maximum function is gained during this period.

Some people wondered whether not having a hand for so long might not undermine the outlook. Cendales said it makes not difference how long ago the person had lost their hand. History of hand transplants In 1964 in Ecuador a transplant was performed - within two weeks the patient's body rejected it.

Clint Hallam, from New Zealand, lost a hand while a prisoner. He received a hand transplant in 1998, in Lyon, France. However, he did not comply with follow-up instructions regarding prescription medications and physical therapy, etc., Following an episode of rejection of the hand by his body, Hallam asked for it to be removed. In short, he had a donor hand for two years. At this point, medical professionals realized that a whole team of caregivers are required, including psychologists.

In 1999, Matthew Scott, who had lost a hand in a fireworks accident, underwent a hand transplant in New Jersey, USA. The operation was performed by Drs. Warren Breidenbach and Tsu-Min Tsai from the University of Louisville. The Kleinert Hand Institute and Jewish Hospital in Louisville, Kentucky also cooperated. Later on that year he used the transplanted hand to throw the first ceremonial pitch for the Philadelphia Phillies.

Surgeons from the University of Innsbruck, Austria carried out a series of three bilateral hand transplants over six years, starting in the year 2000. One of their patients, a police officer, went on to complete a round-the-world solo motorcycle trip.

In 2001, the Drs. Warren Breidenbach and Tsu-Min Tsai performed a hand-transplant operation on Jerry Fisher, from Michigan, and then in 2006 another one on David Savage, also from Michigan. Both were successful.

In 2004, Professor Jean-Michel Dubernard, and team of the Edouard-Herriot Hospital, France, declared a hand-transplant operation a success after the recipient had used it for over five years. This procedure, and 26 others encouraged other surgeons to perform various transplants, including the larynx, abdominal wall and the face.

The first double hand transplant to take place in the USA was in 2009, by Dr. W.P. Andrew Lee and team from the University of Pittsburgh Medical Center.

In 2010, a Polish soldier who had lost both his hands while saving a colleague from a bomb received two new hands.

On 8th March, 2011, at the Ronald Reagan UCLA Medical Center, a 26-year-old female received a right hand.