Transplant, hand and forearm
Transplantation of the hand and the forearm from one person (a deceased donor) to another (the recipient).
In the first hand transplant, performed in Ecuador in 1964, the donor hand was rejected after two weeks. The first successful hand and forearm transplant was done in 1998 in Lyon, France. In 1999, surgeons in Louisville, Kentucky, repeated the feat. Both the Lyon and Louisville recipients enjoyed some regeneration of nerves providing sensation and function in their new hands but neither regained full function.
The first double hand-and-forearm transplant was done early in 2000 in Lyon, France. The recipient, a 33-year-old man, had lost his hands in a fireworks accident. The donor was a 19-year-old man who had fallen off a bridge and was brain dead.
Hand transplants are still highly experimental and controversial. Although loss of a hand is a major handicap, a hand are not necessary to live and the anti-rejection drugs pose many risks and must be taken for life. Critics have therefore raised a number of ethical issues about transplanting hands (and other parts of the body a person can do without). The issue is really related to transplantation of one vs. two hands. A person lacking one is not as disabled as one who has lost both. Considering the side effects of anti-rejection drugs, much of the controversy centers around a single hand transplant, less so in the double hand transplant. Patient selection is extremely important, as in any transplant patient, as the graft will be lost with noncompliance.
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