Hand Transplant

1 What is a Hand Transplant?

A hand transplant is basically a treatment option for individuals who have had either one or both of their upper limbs amputated.

In this procedure, you are given one or two hands from a donor and a portion of a forearm from a deceased individual.

A hand transplant is not common procedures, they are only performed in a few transplant centers around the globe.

There is no guarantee, but a hand transplant can help you some hand function and sensation. while a hand transplant can better your quality of life, it is a lifelong commitment to treatment.

Special medication known as immunodepressants must be taken and have routine doctor appointments and physical therapy to check the condition of the donor's hands.

2 Reasons for Procedure

Here are the most common reasons to undergo a hand transplant procedure.

A hand transplant can only be an option in specific cases selected in an attempt to improve the quality of life and give you some degree of function and sensation in your new hands.

When making matches between you and your donor hand for a hand transplant, doctors take note of the following:

  • Blood type.
  • Tissue type.
  • Skin colour.
  • Comparable ages of the donor and the recipient.
  • Same sex between donor and recipient.
  • Hand size.
  • Muscle bulk.
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3 Potential Risks

A hand transplant is accompanied by various potential risks, including:

Surgical risks. A hand transplant is generally a very major and complex procedure and carries all risks related to surgery. Including an infection, bleeding and a blood clot formation (thrombisis).

Rejection risks. When your body's immune system treats your donor's hand as a foreign body, which is the same kind of reaction it treats bacteria or viruses.

This will further lead to the destruction of the donor hand by your immune system. Rejection occurs in two major ways: Acute rejection.

Acute rejection happens when the body tries to quickly the tissue in your donor's hand. If you have acute rejection, you may notice a rash, swelling or change in skin colour of your hand or arm.

Acute rejection can be controlled with specific medications, but in very uncommon cases,  you may need to have the donor's hand removed. Chronic rejection. 

This kind of rejection happens over a lengthy period. In this situation, your hand may become painful and lose function. You may also take notice of a loss of hair on your hand or particular changes in your fingernails.  

You will be taught how to notice the early signs of rejections. Report any changes in the appearance and sensation of your transplant team.

Immunoderessant risks. Immunodepressant drugs are certain medication administered to prevent your body from rejecting your donor hand or hands.

These medications are so potent that you will be required to take them for the rest of your life.

The major side effects include:

4 Preparing for your Procedure

Evaluating whether to have a hand transplant. To prepare for a hand transplant, carefully consider the risks involved in it and whether you can be committed to intense follow-up care that will last for the rest of your life.

Post-transplant care includes Regular appointments with your transplant team. Regular physical therapy. Daily taking of immunodepressant drugs.

Follow-up care with your primary care doctor for routine health screenings. You will be evaluated by the health care team. Individuals who have an amputation at the mid upper arm or below may be considered for a transplant.

To be considered a candidate for a hand transplant, one must: Pass a comprehensive physical exam that includes X-rays, blood tests etc. Pass a mental and emotional evaluation.

Have no history of chronic nerve conditions. Have no serious medical complication. Have had no recent serious infection. Be a nonsmoker.

Complete a financial evaluation of post-transplant care expenses with a member of the transplant team. Getting ready for your hand transplant. After approval, you will be placed on a waiting list for the donor of hands.

It is impossible to predict the wait time since it is not usually known when a donor hand or hands will match your needs. In the meantime, prepare as much as possible for a transplant.

Preparations include Transplant clinic visits. You will need periodic appointments with your transplant team for blood tests and ongoing evaluations of your transplant readiness.

Strengthening exercises, if recommended. Arranging for travel and lodging. Communicating with your transplant team.

If you have any changes to your medical care, including changing medications, having a blood transfusion or being diagnosed with a serious medical condition, let your team know immediately.

Also, be sure to communicate any changes to our address, phone number or family contact information.

5 What to Expect

Here’s what you can expect before, during, and after your hand transplant procedure.

During the procedure. Hand transplant surgery is a complex operation that can take 18 to 24 hours to perform. A team of surgeons will perform your surgery and provide your family with periodic updates on how your surgery is progressing.

Once the donor's hand is ready to be attached to your arm, your surgeons will first attach your bones to the bones of the donor hand using small metal plates.

Your surgeons will then use special sutures (stitches) to attach the blood vessels, nerves, and tendons. Surgeons use a special operating room microscope to place the sutures.

Once all the parts of the donor's hand and recipient's arm have been attached, the skin is closed. After the procedure After your surgery, you'll be placed in an intensive care unit (ICU).

Your health care team will check for function in your donor hand or hands, and you'll be asked to try to move your fingers. It's possible the room that you stay in will be kept at a higher temperature to promote blood circulation in your donor hand or hands.

Once you're stable enough to leave the ICU, you'll move to a different hospital room. You can expect to stay in the hospital for seven to 10 days following your transplant.

Your health care team will help you manage your pain following your transplant. It's important to communicate to your team how serious your pain is, since managing your pain can speed up your recovery.

A special hand therapist also will work on physical therapy with you while you're in the hospital. He or she will teach you exercises to get your hand functioning. In between exercise sessions, you'll wear a splint on your hand to keep it stable.

You'll also be taught exercises to perform on your own. It's normal to have some emotional concerns soon after your surgery. You may have trouble sleeping and adjusting to your new routine of caring for your donor hand or hands.

Talk to members of your transplant team if you have any emotional concerns. Immunosuppressant medications can help stop your immune system from destroying your donor hand or hands.

Following your procedure, you'll begin to take immunosuppressant medications and will continue to do so for the rest of your life.

To decrease the risk of side effects from immunosuppressant medications and the risk of rejection, you should:

  • Take your immunosuppressants at the same time and in the same way every day (with or without food)
  • Never stop taking the medications unless directed to do so by a doctor
  • Expect side effects from the medications, and work with your transplant team to minimize the side effects Have regular blood tests to check the effectiveness of your immunosuppressants

While immunosuppressants can help reduce your risk of rejection, they can also lower your body's ability to fight off infections.

If you have any signs that you're becoming ill with an infection — such as fever, rash or swelling — contact your transplant team or your doctor.

6 Procedure Results

Because hand transplants are a relatively recent procedure in medicine, it is not easy to predict the results of the procedure.

After your post-transplant care plan can increase your chances of regaining as much function and sensation as possible.

Although there is no guarantee on how much hand function you will gain, hand transplant recipients will be able to:

  • Pick up a small object, such as nuts and bolts.
  • Lift heavier objects with one hand.
  • Use a wrench and other tools.
  • Take change into an outstretched palm.
  • Use a knife and fork.
  • Tie shoe laces.
  • Catch a ball.
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