A 51-year-old man has become the first person in Britain to have a full hand transplant after a donor was found on Boxing Day. Mark Cahill spent eight hours in surgery at Leeds General Infirmary during which doctors replaced his disabled right hand with the donor’s limb.
A spokesman for the surgical team said the operation went well and, if the limb continues to survive, the patient is expected to gain feeling and movement in the transplanted hand. Cahill’s hand became disabled as a result of an infection following a severe case of gout.
Cahill, from Greetland, near Halifax in West Yorkshire, said: “It feels great to look at this hand I haven’t seen move for five years and see it move. I would say to other people, absolutely, go for it. Anything is better than what I had before this operation.
“I’m hoping to eventually go back to work. I’m already moving my fingers, the doctors say I’m making quicker progress than they expected.
“Before the operation I couldn’t tie my own shoes, do up my shift buttons, cut my dinner or play with my grandson’s toys with him. Hopefully I’ll be able to do all these things now.”
The surgical team said they used a new technique that involved amputating Cahill’s non-functioning hand during the same operation as the donor hand was transplanted.
In the operating theatre, the surgeons worked in two teams alongside each other. One team removed the donor’s hand, while the other removed the patient’s. The arrangement allowed them to map the nerves and blood vessels in intricate detail before transplanting. The doctors reattached eight blood vessels, three nerves, tendons and bone in the complex procedure.
This procedure allowed very accurate restoration of nerve structures and is believed to be the first time this approach has been used, surgeons said.
Simon Kay, professor of hand surgery, and a member of the team, added: “He’s pleased to have come through this and have a hand, but he’ll take it one day at a time, as we all will.
“The donor’s family made this decision in the midst of their grief at Christmas time and that is an extraordinary act. It brought it home to me, how I would have felt. It plucks something positive from something awful.”
The team has been working closely with NHS Blood and Transplant and also colleagues in Lyon, France, where hand transplants were pioneered in 1998.
Surgeons at the hospital began looking for suitable donors for the operation more than two years ago. The team had been on standby since November, and heard late on Boxing Day that a suitable donor had been found.
Hand transplants have been controversial because patients must take drugs to suppress their immune systems, which can be harmful and even shorten their lives.
With common transplants, such as hearts and livers, the decision is quite straightforward, because the patients will not survive without the new organ.
Doctors assessed several patients medically and psychologically before choosing Cahill as the first to undergo the operation. He had lost all function in his hand and was due to have it replaced with an artificial hand. It may take six months to a year for the nerves to heal and for him to gain feeling and movement in the transplanted hand.
Kay said the operation was not suitable for all of the people the team assessed. Cahill was selected because he was the best tissue match. “We looked at a lot of patients and the majority, for one reason or another, were not suitable. This is only going to be one of a number of ways to help people with lost limbs,” he said.
The first-ever recipient of a hand transplant was New Zealander Clint Hallam, who had his operation in France. Hallam lost his original hand in a circular saw accident in prison in 1984. He eventually decided he could not live with his new hand, which was taken from a motorcyclist who died in an accident. He said it felt like a dead man’s hand. It was removed two years later. Doctors said Hallam had not stuck to the correct drugs and exercise regime.
By Ian Sample
Courtesy of The Guardian