UPMC On Topic Transcript
Hand Transplantation
Vijay Gorantla, MD, PhD
Administrative Medical Director, Reconstructive Transplant Program
Hand transplantation is for a select population of patients who either do not benefit from or do not desire prosthetics.
When you really look at certain prosthetics they are really not — they don’t look normal. So there are several amputees who have rejected prosthesis based on the very fact that they don’t really look normal.
And most importantly, prosthetics do not have the ability to touch and feel like a human hand does.
In the world experience greater than 90 percent of patients who have had hand or arm transplants have regained motor ability in terms of motion, power and strength, as well as have reported ability to feel sensations such as touch, vibration, shapes, temperature, and pain.
Minimizing immunosuppressants
Hand transplant is technically not a challenging surgery because it’s been done for many, many years in the form of replantation.
The reason why hand transplants have not become a wider clinical option around the world is the fact that patients have to take high doses of multiple drugs for a lifetime after transplantation.
So we’ve used our research expertise and also our clinical experience in transplantation over the years and developed an innovative protocol which is an antirejection therapy that allows us to reduce drugs from two or three drugs to one drug.
Making the hand work
The unique aspect of hand transplants is that unlike organ transplants is you have to really train the hand to, to function. Unlike an organ, the minute you connect the blood vessels it starts beating and functioning. In hand transplants, nerves have to regrow into the hand from your body as a recipient, and you have to train these nerves into, you have to train these muscles into functioning by undergoing rigorous therapy.
We at UPMC have performed the first double hand transplant and also the, the first full total forearm transplant. We also are the largest number of transplants performed at a single center in the world.
Road to recovery
We’ve had patients when asked what was the most important aspect that they gained out of a hand transplant, we’ve had responses like the ability to clap, the ability to touch and feel their baby and the ability to be independent with personal activities.
So these may look as insignificant to people who have both hands, but they are indeed very important for amputees.
For more information, contact us at 412-648-9207.