UK's first hand transplant operation

 
Surgeon with Mark Cahill Mark Cahill, right, can wiggle the fingers on his new hand

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A former pub landlord from West Yorkshire has become the first person in the UK to have a hand transplant.

Mark Cahill, who is 51, had been unable to use his right hand after it was affected by gout.

Doctors say he is making good progress after an eight-hour operation at Leeds General Infirmary.

It is still very early to assess how much control of the hand will be gained - so far he can wiggle his fingers, but has no sense of touch.

'My hand'

The new hand

It is early days to assess what level of function Mr Cahill will achieve with his new hand.

Surgeons hope that within 18 months it will be a huge improvement on what he had before.

Prof Simon Kay said: "I would hope that he has a quite a strong grasp, good sensibility in the hand, good ability to feel and a precision pinch."

Both doctors and patient are pleased so far.

Hand transplants raise more ethical questions than other transplants, such as the heart, as they improve the quality of life rather than saving a life.

Yet Mr Cahill will need a lifetime of drugs to suppress his immune system in order to stop his body rejecting the donor hand. This can leave him vulnerable to infection.

Mark Cahill, from Greetland near Halifax, said: "When I look at it and move it, it just feels like my hand.

"Right now it feels really good, it's not a lot of pain, it looks good, it looks a great match and I'm looking forward to getting it working now."

Mr Cahill's new hand is still bandaged up, but he can already move his fingers. It is hoped that with time he will gain much greater levels of movement and sensation.

He developed gout in his toes and feet 20 years ago. Five years ago it spread to his right hand leaving him unable to open his fingers or use his hand for anything.

One option would have been a bionic hand, but he volunteered for the pioneering surgery.

As well as being a first for the UK, it was also the first time a recipient's hand has been amputated during an operation to attach a donor hand.

The fresh cut, made where you would wear a watch, allowed surgeons to connect nerves in Mr Cahill's arm with those in the donor hand with great precision - along with the bone, blood vessels and tendons.

Graphic explaining the operation

The operation took place on 27 December when a donor hand became available.

Hand Mark Cahill's old hand swollen by gout
'Extremely challenging'

Prof Simon Kay, a consultant plastic surgeon at the hospital, said: "The team was on standby from the end of November awaiting a suitable donor limb, and the call came just after Christmas.

"It was extremely challenging to be the first team in the UK to carry out such a procedure.

"It is still early days but indications are good and the patient is making good progress."

He also paid tribute to the donor and their family.

Milestones

  • Transplants have a long history with the first taking place more than a century ago - in 1905. Alois Glogar was blinded in an accident working with lime. Dr Eduard Zirm grafted corneas from an 11-year-old boy onto both eyes - one failed, but the other allowed Mr Glogar to see.
  • The first successful kidney transplant took place in 1954 between identical twins.
  • Dr Christiaan Barnard was the first to perform a successful heart transplant in South Africa in 1967.
  • The first hand transplant was in 1998.
  • In 2005 the first partial face transplant was carried out in France. Isabelle Dinoire, who had been mauled by her dog, was given a new nose, chin and lips.
  • The first full face transplant took place in 2010.

Leeds General Infirmary already has a reputation for reattaching hands which have been accidentally cut off.

This operation has been planned for more than two years and the hospital was in touch with plastic surgeons across the country looking for people who might be suitable.

Potential patients had to be assessed - both physically and psychologically - to ensure they were suitable for the procedure.

The surgical team also liaised with surgeons in France who performed the first hand transplant in 1998.

'Mentally detached'

The first recipient was Clint Hallam, from New Zealand, who had lost a hand in an accident with a circular saw more than a decade earlier.

He later had the hand removed, complaining it was like a dead man's hand with no feeling in it.

He said he felt "mentally detached" from the transplant, which was wider and longer than his own. The skin was also a different colour.

Clint Hallam Clint Hallam received the world's first hand transplant

Surgeons do try to find hand transplants which are a close physical match to a patient, however, they are very visible, unlike a transplanted internal organ such as a kidney.

Ensuring a patient is prepared for the mental challenge of living with a hand which is not their own is considered as important as the surgical element of the transplant.

More than 60 hand transplants have been carried out around the world.

Prof Norman Williams, the president of the Royal College of Surgeons, said: "This is yet another example of life-changing surgical advancements that are now possible."

"As with all procedures that improve the quality of life rather than save it, there is an ethical balance to be struck - especially as the lifelong anti-rejection medication that the patient would need to take carries its own risks.

"Care always needs to be taken in choosing suitable patients who understand the risks and benefits."

 

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  • rate this
    +1

    Comment number 156.

    This is a magnificent technical achievement, but I am not sure that I personally would want it. The long term effects of taking immuno-suppressant drugs are not fully understood, but can result in complications and in extreme circumstances cancer. A risk worth taking if the alternative is death, as with a heart transplant, but not in my view just for a new hand, but that is a personal choice.

  • rate this
    0

    Comment number 90.

    I think transplants are the best we can do right now, but face dangers - rejection, medications, etc.
    It would be better if we could grow a new hand. From what I read this seems feasible and would insure no rejection. Growing new organs, like hearts and livers is the future of body-part replacement.
    I respect the transplanters; it's just beginning to seem obsolete.

  • rate this
    +20

    Comment number 85.

    I find this report fanastic as I myself lost my right hand following an RTA in 1963! progress in the world of medicine since then has been simply amazing. My best wishes to the gentleman, & my compliments to the surgical team who carried out this brilliant proceedure!

  • rate this
    +23

    Comment number 76.

    I have to 'hand' it to the surgical team. Many years ago I put a stanley knife through my hand between the thumb and first finger. My surgeon did a brilliant job of getting me the use back by re-attaching the nerves and transferring an unused tendon from my arm. I have every admiration for the team and wish the patient a speedy recovery.

  • rate this
    +21

    Comment number 67.

    Good luck and great hopes for all connected to this amazing project - we hope Mark Cahill continues to do well and get good use from his hand. Congratulations also the to donor family who made such a generous gift and difficult choice to aid others.

 

Comments 5 of 9

 

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