Jith Kumar Saji, 21, can’t stop smiling and swinging his arms about since he’s got a new pair of hands to replace the ones he lost from the elbows down from electrical burn injury when he fell on live high-tension wire in 2013.
On May 24, Saji became India’s third double-hand transplant recipient and the first one to get a forearm transplant. All three transplants have been done at the Amrita Institute of Medical Sciences (AIMS) in Kochi, which is the only centre doing hand transplants in India.
All the three transplants have been bilateral, which means both hands have been transplanted in a single surgery.Forearm transplants – for patients with hands missing from the elbow – are very challenging and attempted only a few times in the world
Give them a hand
A team of 25 surgeons and 12 anaesthetists led by plastic and reconstructive surgeon Dr Subramania Iyer worked together to preserve as much tissue as they could and transplanted the new hand over them. The entire surgery on Saji, including the retrieval and transplantation, took 14 hours and was done free.
India’s first hand transplant recipient was Manu TR, then 29, who got new hands on January 12, 2015. The second recipient was Captain Abdul Rahim from Afghanistan’s BSF, who had lost both his arms while defusing a bomb near Kabul.
The three surgeries have put India among a handful of countries -- including the France, US, Germany, UK, Canada, Iran and China -- that have successfully done hand transplants worldwide.
The forearm transplant is surgically more challenging than the wrist and hand transplants because the muscles that move the hand, fingers and thumb are located in the forearm, which was badly damaged by the electrical burns in Saji’s arms.
“In trans[plants done above the wrist, the tendons are still connected, but in a forearm transplant, these connections have to be made to the muscle mass. Identification, tagging and connecting the nerves, tendons and arteries is very challenging,” says Dr Iyer.
Saving lives in death
Donors are accident and trauma victims with certified “brain death”, a term used to describe irreversible loss of all brain function that stops the heart and lungs from working.
Saji’s donor was Raison Sunny, 24, who was declared brain dead after a scooter accident in Angamaly, 30 km away from Kochi. “Unlike internal organs retrieval, retrieving donor arms leads to visible amputation, which is traumatic for the family with even when the retrieved arms are replaced by prosthetics. Sunny was part of a volunteer group that took accident victims to hospitals and his family readily agreed,” says Dr Jimmy Mathew, who was part of the team that did the surgery.
Saji was discharged on Friday but will continue physiotherapy for two years to regain complete hand function and take immunosuppressant medicines for life to stop his body from rejecting his transplanted hands.