Bilateral Hand Transplant

A bilateral hand transplant is a complex surgical procedure that involves transplanting two donor hands onto a recipient who has lost or is born without hands. This procedure is also known as a double hand transplant.

Indications

The primary indication for a bilateral hand transplant is to restore hand function and improve the quality of life in individuals with bilateral hand loss or severe hand deformities. This can include:

• Amputations due to trauma, infection, or tumors
• Congenital hand anomalies
• Severe burns or injuries that result in significant hand damage

Surgical Procedure

The bilateral hand transplant procedure involves a team of surgeons, including plastic surgeons, orthopedic surgeons, and microsurgeons. The surgery typically takes 12-18 hours to complete and requires:

• Harvesting the donor hands, which includes dissecting the blood vessels, nerves, tendons, and muscles
• Preparing the recipient's arms for transplantation, including cleaning and preparing the bone, nerve, and blood vessel ends
• Attaching the donor hands to the recipient's arms using microsurgical techniques to connect the blood vessels, nerves, and tendons
• Reattaching the muscles and skin to restore hand function and appearance

Post-Operative Care

After the surgery, the recipient will require:

• Intensive care unit (ICU) monitoring for several days to manage pain, prevent infection, and ensure graft survival
• Immunosuppressive medication to prevent rejection of the transplanted hands
• Physical therapy to regain hand function, including range of motion exercises, strengthening, and sensory reeducation
• Regular follow-up appointments with the transplant team to monitor graft function and adjust immunosuppression as needed

Risks and Complications

As with any major surgical procedure, there are risks and complications associated with bilateral hand transplantation, including:

• Graft rejection or failure
• Infection
• Nerve damage or numbness
• Blood vessel thrombosis or occlusion
• Immunosuppression-related side effects, such as diabetes, hypertension, or kidney disease

Outcomes and Prognosis

The outcomes of bilateral hand transplantation can vary depending on the individual recipient's condition and the success of the transplant. In general:

• Most recipients experience significant improvements in hand function, including grasping, gripping, and manipulating objects
• Sensory recovery can take several months to years, with some recipients experiencing near-normal sensation
• Motor function recovery can take longer, with some recipients requiring ongoing physical therapy to maintain and improve hand function