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The Untold Story of the First Hand Transplant: Dedicated to the Memory of one of the Great Minds of the Ecuadorian Medical Community and the World.
- Source :
-
Journal of reconstructive microsurgery [J Reconstr Microsurg] 2019 Mar; Vol. 35 (3), pp. 163-167. Date of Electronic Publication: 2018 Aug 31. - Publication Year :
- 2019
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Abstract
- Background: In 1964, faced with the challenge of traumatic amputation, a team of surgeons at Clinica Guayaquil was convinced that the transplantation of a hand could significantly improve function and quality of life for the recipient. With a current but basic understanding of immunosuppression, the surgeons identified a recipient and waited for the correct donor. A human hand transplant had never been performed to date.<br />Methods: The surgeons' criteria for the recipient included a young healthy individual who had sustained a traumatic amputation at the distal forearm level with full motion of the proximal joints. Communication with receiving hospitals and military facilities identified what they perceived to be a feasible donor for an allograft transplantation. Consent was obtained from the family in conjunction with the local military medical authorities and the clergy. Iced saline solution and Heparin irrigation were to be used to prepare the donor extremity. The immunosuppression regimen, limited at the time, consisted only of intravenous cortisone, Imuran, and a single dose of radiation.<br />Results: A member of the Ecuadorian marine sustained a limited blast injury that amputated his dominant hand but spared the forearm. He was transferred to the emergency department of Clinica Guayaquil. A donor who had recently died in a nearby hospital was identified not long after. A successful technical surgical transplantation was achieved. Consultants from major hospitals around the world (including Peter Bent Brigham Hospital) convened at the patient's bedside to observe the results. Despite all efforts, the patient suffered an irreversible rejection at 21 days post-transplant.<br />Conclusion: This was the first allograft transplantation of a hand. The surgeons embarked on an intervention never tried before, firmly believing that better function and quality of life would result. The bravery of this surgical team was commendable. This early surgical endeavor opened the way for future successes in transplant surgery today.<br />Competing Interests: Disclosure The authors report no conflicts of interest in this work.<br /> (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Subjects :
- Adult
Amputation, Traumatic physiopathology
Amputation, Traumatic surgery
Ecuador
Forearm physiopathology
Graft Rejection physiopathology
Hand Transplantation methods
History, 20th Century
Humans
Male
Quality of Life
Plastic Surgery Procedures methods
Treatment Failure
Amputation, Traumatic history
Forearm surgery
Graft Rejection history
Hand Transplantation history
Immunosuppression Therapy history
Plastic Surgery Procedures history
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8947
- Volume :
- 35
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of reconstructive microsurgery
- Publication Type :
- Academic Journal
- Accession number :
- 30170326
- Full Text :
- https://doi.org/10.1055/s-0038-1668535