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Insight

'My new hands are tremendous'

Rebecca Drew
26/07/2016

In the world, around 80 hand transplants have taken place, but Chris King has become the first person to undergo a double hand transplant in the UK since the NHS launched their hand transplant programme in April this year.

The NHS estimate that following the launch of the programme, each year two to four patients in England could benefit from the breakthrough surgery. The new limbs provide the patient with a warm limb that will be able to do far more than a prosthetic. If all goes well with the surgery and recovery, the patient's new hand will be able to move with strength, sense its surroundings, feel warm to touch and heal itself when injured.  The operations are estimated to last up to 16 hours and cost the NHS an estimated £50,000. Consultant Plastic Surgeon, Professor Simon Kay performs the operations at Leeds General Infirmary.

Three years ago, Chris King suffered a devastating injury at work when he was involved in an accident with a metal pressing machine. His injuries were so extensive he lost four fingers on each hand. He has now become the UK's first double hand transplant patient.

Following a painstaking 12 hour operation performed by Professor Kay, Chris says that he:

Chris can be seen talking about his surgery here on the BBC's site

Not only is this the first double hand transplant, but Chris' surgery is the first hand transplant not to be done above the wrist, but rather with the substance of the hand. Professor Kay explains that this type of surgery is far more complex and difficult; he comments that 'there was more to think about when transplanting hands rather than internal organs. Nobody cares what their kidney looks like as long as it works. But not only do we have to match the hands immunologically, in the same way that we have to match kidneys and livers, they also have to look appropriate because the hands are on view the whole time.

The operations involve four teams of surgeons working simultaneously; one removes the donor's hand(s) while the other performs the transplant. Surgeons often refer to this kind of surgery as 'hand and upper limb reconstruction using vascularised composite allotransplantation.

The broken bones are held together by titanium plates and microsurgery is used to connect key blood vessels and nerves. The tendons and muscles are then attached before the patient's skin is closed.  

When considering the surgery there is a process applicants must go through before they are accepted, with particular emphasis placed upon their psychological and physical suitability for the surgery.

Following a screening of 20 patients for surgery, just two were deemed suitable and it is not surprising that matches are rare. There is the necessity for matches of skin tone, blood group and hand size to be taken into consideration. Patients also have to accept that their transplant may not be successful and their body may reject the new limb. Following surgery they receive intensive physiotherapy and counselling. The patient will also remain on anti-rejection medication for the rest of their life.

This surgery is quite extraordinary and certainly life changing for the patient concerned. The transplant programme is undoubtedly a large cost to the NHS but with a maximum of four patients per year receiving this pioneering medical treatment and the statistics from the International Register for Hand and Composite Tissue Transplantation reporting that two in five patients described their transplant as excellent, 53% good, and 7% fair, when considering the NHS' 'cosmetic, sensory, functional and social outcomes'.

Currently, there are four people on the waiting list for the procedure and with no negative feedback so far, the chances of a positive outcome far outweigh the chances of a negative outcome.

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