Britain Conducts Hand Transplantation
Surgeons carry out Britain's first hand transplant A grandfather has undergone Britain’s first hand transplant, saying he has already gained movement of his fingers following the "dream" operation.
Mark Cahill expressed delight at his “brand new hand” saying it would enable him to cut up his own food once more, dress himself, and play properly with his grandson.
The 51-year-old, a former publican, was left with a functionless right hand as a result of gout and a subsequent infection. For five years it had been totally rigid.
But on December 27 a specialist team at Leeds General Infirmary amputated it, replacing it with the donor hand during an eight-hour operation.
The procedure involved mapping all the nerves, blood vessels and tendons on both hands to ensure the best possible result.
Although this hand transplant is not a world first - that happened in France in 1998 - it is the first time surgeons anywhere have carried out a hand amputation simultaneously.
Mr Cahill can already move his new fingers and is progressing better than expected.
The new limb was a surprise for the patient, from Halifax, who only signed up to the hospital’s unique hand transplant programme in October.
On Boxing Day he received the call that he was the best match for a donor hand that had become available. Within 24 hours he was under the knife.
Speaking last night, Mr Cahill said: “The operation has changed my life.
“Before the op, I couldn't tie my own shoes, do up the buttons on my shirt, cut up my own dinner or play with my grandson's toys with him - hopefully I'll be able to do all these things now."
He added: “When I got the call on Boxing Day to say there was a donor I was gobsmacked.
"I really expected quite a wait, and it was a bit of a 'gulp' moment. My wife Sylvia and I were meant to be going on holiday to Goa this week, but this is obviously a much better turn-out.”
"It didn't feel real until I woke up after the op,” he confessed. “It felt like a dream, even when I was going into theatre.”
He was, however, realistic about how the hand would look. At present bandaged to aid the healing process, he admitted it did look different to the original - something that is hardly surprising but can be overlooked.
“It's how I expected it to look, because I've done a lot of research about hand transplants,” he said.
"But you can do all the research you want but you don't know how you're going to feel.
“I've had a lot of help from psychologists because the biggest thing is afterwards, whether I would accept it as mine.”
Save the medical difficulties of the operation, this has been one of the surgeons’ biggest worries.
The recipient of the world’s first such transplant, a New Zealander called Clint Hallam, had it amputated in 2001, saying it felt like “a dead man’s hand”. Doctors said Hallam, an ex-convict, had failed to take proper care of it.
But Mr Cahill was last night talking as if the hand was truly his: "It feels great to look at this hand I haven't seen move for five years and see it move.
“I would say to other people [considering hand transplantation]: absolutely, go for it.”
He described how he had been convinced by Professor Simon Kay, the consultant plastic surgeon who led the operation, to sign up as a potential hand transplant recipient.
“I went to Professor Kay at first thinking he may be able to do something to repair my hand and I've come out with a brand new one,” he said.
The operation marks the end of a decade-long quest for the specialist hand surgeon, who has led the effort to bring hand transplantation to Britain.
He helped set up a multi-disciplinary team containing surgeons, immunologists, dermatologists, psychologists and rehabilitation experts.
For over a year they have been actively recruiting potential recipients and awaiting the moment that a suitable donor hand would become available, resulting, of course, from the tragic death of the anonymous donor.
Prof Kay described the operation as “extremely complex”. He said: “We had two operating teams side by side, with one taking off the rigid hand bit-by-bit while the other marked the donor hand for attachment.”
Nerves, blood vessels and tendons were marked on each hand to ensure the best possible fit.
The donor hand was then attached just below the wrist: firstly the bones, then some tendons, and then the blood vessels. After circulation was restored, the remaining tendons were connected and the nerves repaired.
A skin graft was not necessary because there was enough skin remaining for produce a flap to cover the join, he said.
Prof Kay said early signs were encouraging, but held a note of caution.
“We are through the first week and I’m cautiously optimistic,” he said. “But we are not out of the woods yet, and we could still lose it. We are going to be very vigilant for a long time before we are happy.”
Prof Kay also paid tribute to his colleagues - emphasising it was a team effort - as well as the donor’s family.
He said: “I felt very anxious but I'm incredibly proud of the team - everyone from the surgical team to the psychologists who supported Mark.
"We couldn't have done this without a hospital with the expertise the Leeds General Infirmary has.
"And of course we should thank the donor - you can't imagine anything more tragic than a family member dying unexpectedly at Christmas.
"We should pay tribute to the family that donated so that some positive came about."