Kochi, Sept 17: A private hospital here has achieved a rare feat by conducting the country’s first shoulder-level full-arm transplant.
A patient from Karnataka and another from Iraq, who lost both their hands due to electric shock, have successfully undergone bilateral hand transplants at Amrita Hospital in the city, with limbs harvested from donors who were victims of fatal road accidents in Kerala.
The men, 25-year-old Amaresh and 29-year-old Yousif Hasan Saeed Al Zuwaini, hail from different backgrounds and countries.
“The transplanted hands on Amaresh belonged to Vinod, a 54-year-old man who was working in a gulf country. On a visit to his native place in Kollam district, Kerala, he had a fatal traffic accident when his motorcycle collided with a private bus. Vinod suffered a serious head injury and was admitted to the Government Medical College, Thiruvananthapuram. Despite the best efforts of doctors, he could not be revived and was declared brain dead on January 4, 2022. Vinod’s family readily agreed to donate his various organs, including his hands, following his death,” the hospital said in a release.
Amaresh, who is unmarried, suffered a severe injury in September 2017 due to electric shock while repairing a charged electric cable. His hands sustained multiple fractures and electric burns. He was rushed to a hospital where doctors had to amputate both his hands to save his life. While the right hand was amputated at the elbow, the left hand had to be severed right at the shoulder level, the hospital said.
Amaresh later approached the hand transplant team of Amrita Hospital and subsequently got registered in the Kerala Network for Organ Sharing (KNOS) in September 2018 as an organ recipient waiting for organ transplantation.
“After a pair of hands were harvested for transplantation from Vinod, Amaresh was rushed to Amrita Hospital on January 5, 2022, where Dr. Subramania Iyer and Dr. Mohit Sharma led a team of 20 surgeons and 10 anesthetists to successfully transplant both the limbs in a marathon surgery,” the hospital said.
Dr Iyer, who is a Professor and Head at the Centre for Plastic and Reconstructive Surgery at the Amrita Hospital, said it was a very complicated operation.
“Shoulder-level full-arm transplants are quite rare. In fact, this is only the third such surgery in the world. The higher the level of amputation, the more challenging the hand transplant becomes. There are profound technical issues in a shoulder-level transplant, especially fixing the donated upper limb to the shoulder of the recipient. Amaresh’s surgery was successful. There was a problem with the blood supply to the upper limb, which we could solve only with two subsequent procedures. Finally, the patient was discharged three weeks after the surgery,” Dr Iyer said.
Meanwhile, Yousif Hasan, an interior construction worker from Baghdad and a father of two girls, was involved in an accident in 2019 when he was drilling a wall.
The driller unexpectedly came into contact with a concealed high-voltage electric cable, electrocuting him instantly. He was rushed to a hospital, where doctors had to amputate both his hands from the elbow to save his life.
“Six months after the accident, Yousif arrived at Amrita Hospital in Kochi to learn more about the hand transplant procedure and in July 2021, registered with the Kerala Organ Sharing Registry called KNOS as an organ recipient waiting for organ transplantation,” the hospital said.
A 39-year-old woman, Ambily, an Alappuzha native, met with an accident and was rushed to Amrita Hospital where she was declared brain dead. Her family readily agreed to donate her organs, including the hands, for those in need. On February 2, 2022, Ambily’s hands were successfully attached to Yousif in a 16-hour surgery, led by Dr. Iyer and Dr. Sharma.
Dr Iyer said both the hands had to be fixed at the forearm level.
“Some blood vessels were difficult to connect to. This was solved by using grafts. The patient was also discharged three weeks later and is doing fine now,’ he said.
Amrita Hospital pioneered hand-transplants in India by conducting the country’s first such transplant on a 30-year-old man, Manu, in January 2015, with the surgery team led by Dr. Iyer. With these two surgeries, a total of 11 patients have received hand transplants at Amrita since then.
