Our Summary

This research paper discusses the medical processes and procedures involved in the first ever pediatric bilateral hand transplant. The patient was an eight-year-old boy who had previously suffered a severe infection which led to kidney failure and the loss of both his hands and feet.

A team of medical professionals, including surgeons, anesthesiologists, kidney specialists, intensive care doctors, and pharmacists, worked together to plan and execute the hand transplant operation. Before the operation, the lead surgeon used a 3D printed model of the boy’s forearm to ensure it matched well with the donor’s hands.

During the surgery, an anesthesia team used ultrasound to guide the placement of catheters (tubes) to help blood flow to the new hands and manage pain. The operation took over 13 hours, with the surgical procedure itself lasting over 10 hours. The boy stayed in the hospital for a little over a month after the operation before moving to a rehabilitation center for two more weeks.

Currently, the boy is doing well in a post-op rehabilitation program. He can move his new hands using his forearm muscles, but it is expected to take one to two years before he achieves his maximum level of feeling in the hands.

The research paper concludes that this transplant required significant planning and teamwork. It also highlights the importance of having all necessary resources available for such a complicated and new surgical procedure.

FAQs

  1. What processes and procedures were involved in the first ever pediatric bilateral hand transplant?
  2. How long did the operation take and how was the recovery process for the patient?
  3. What role did 3D printing play in the preparation for this transplant operation?

Doctor’s Tip

A doctor might tell a patient considering a hand transplant that it is a complex procedure that requires extensive planning and coordination among a team of medical professionals. They may also explain that the recovery process can be lengthy, and it may take time before the patient regains full feeling and function in their new hands. It is important for the patient to follow their post-operative care instructions carefully and attend regular follow-up appointments to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for a hand transplant are those who have suffered severe hand injuries or amputations that significantly affect their daily functioning and quality of life. These patients may have lost their hands due to traumatic accidents, severe infections, burns, or congenital conditions. Hand transplants are considered for individuals who have exhausted all other options for hand reconstruction, such as prosthetics or traditional surgeries.

In the case of the eight-year-old boy discussed in the research paper, he was a good candidate for a hand transplant due to the severity of his hand injuries and the impact it had on his ability to perform daily tasks. Additionally, his overall health and ability to tolerate a complex surgical procedure were important factors in the decision-making process.

It is important for patients being considered for a hand transplant to undergo a thorough evaluation by a multidisciplinary team of healthcare professionals, including surgeons, transplant specialists, psychologists, and rehabilitation experts. This evaluation helps determine if a patient is physically and mentally prepared for the surgery and post-operative care required for a successful hand transplant.

Overall, hand transplants are recommended for patients who have lost significant hand function and quality of life due to hand injuries or amputations, and who are deemed suitable candidates for the complex surgical procedure and long-term rehabilitation process. Each case is unique, and decisions regarding hand transplants are made on a case-by-case basis by a team of healthcare professionals.

Timeline

In summary, before the hand transplant, the patient suffered from a severe infection leading to the loss of both hands. The medical team planned and executed the hand transplant operation, which took over 13 hours. After the surgery, the patient stayed in the hospital for over a month and then moved to a rehabilitation center for two more weeks. Currently, the patient is in a post-op rehabilitation program, and it is expected to take one to two years for him to achieve his maximum level of feeling in the hands.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand transplant include:

  1. What are the potential risks and complications associated with a hand transplant?
  2. How long is the recovery process after a hand transplant surgery?
  3. What type of rehabilitation and therapy will be needed after the surgery?
  4. How long will it take for me to regain full feeling and function in my new hands?
  5. Will I need to take immunosuppressant medication for the rest of my life to prevent rejection of the transplanted hands?
  6. How long will I need to stay in the hospital after the surgery?
  7. How will the new hands be matched to my body in terms of size, skin tone, and functionality?
  8. What type of follow-up care will be required after the surgery?
  9. How many hand transplant surgeries have you performed, and what is your success rate?
  10. Are there any alternative treatments or options to consider instead of a hand transplant?

Reference

Authors: Gurnaney HG, Fiadjoe JE, Levin LS, Chang B, Delvalle H, Gálvez J, Rehman MA. Journal: Can J Anaesth. 2016 Jun;63(6):731-6. doi: 10.1007/s12630-016-0625-y. Epub 2016 Mar 7. PMID: 26951450