How can you dislike transplanted hands and want dentures back. Real Frankenstein. Real human hand transplant

In India, local surgeons have successfully transplanted both hands from a donor to 30-year-old Abdul Rahim, an Afghan army captain.

Transplantology studies the possibilities and problems of organ transplantation, as well as the prospects for creating artificial analogues. Today, transplantation allows solving the problems of treating serious diseases. Modern surgeons are able to replace many human organs. The clinics perform successful transplants of the heart, lungs, kidneys, liver, pancreas, intestines and gonads.

But the transplantation of one organ is no longer so relevant. Modern transplantology combines the transplantation of several organs. For example, one lung can be transplanted along with the heart. Moreover, recent advances in medicine have improved the technique of immunosuppressive therapy. Today, toxic drugs are used less and less, and preference is given to substances that are produced by the body itself. These include steroids produced by the adrenal glands, the hormone chareogonin, which is produced in the pituitary gland of the brain, and heparin, which is present in our blood. Substances interact together and thus side effects in transplantation of foreign organs are minimized. An undesirable effect on the body is inevitable with any transplantation, but with this method, a negative outcome is minimized.

In India, local surgeons have successfully transplanted both hands from a donor to 30-year-old Abdul Rahim, an Afghan army captain. Three years ago, he lost both limbs while clearing a mine. Unfortunately, the explosive device went off. The operation lasted 16 hours and involved 20 surgeons. According to the lead surgeon, the transplant required two bones, two arteries, four veins and about 14 tendons for each arm transplant. The man was given immunosuppressants before and after the operation to prevent his body from rejecting the transplanted tissues. Both hands fit well. Lucky can now hold food and even write with his new hands. But the restoration of all motor functions of the hands is not over yet. Doctors say that it will take 3-4 months for a full recovery. In this case, the patient should undergo a course of special physiotherapy. But Abdul will have to take immunosuppressants for the rest of his life. Be that as it may, Indian doctors call this the greatest achievement for their country. But this is not the only hand transplant performed in the world.

For the first time, both hands were transplanted by French doctors 19 years ago. True, after three years they had to be amputated, as the patient could not get used to their presence. The hands were transplanted in Germany in 2008, in the USA in 2009. In 2015, the American boy Zion Harvey entered the history of transplantation as the first child who underwent a successful operation to transplant both hands. Today the boy already plays baseball, eats with a spoon, writes and dresses. And now, two years later, 10-year-old Zion is playing baseball. According to doctors, the boy's brain has fully adapted to the hands received from the donor and now perceives them as his own.

The world's first two-hand transplant in a child was successful under carefully considered circumstances. In a study published in the journal The Lancet Child & Adolescent Health, submitted the first medical report of the operation and 18 months of follow-up.

The transplant was performed on an 8-year-old boy from the United States, who is now able to write, eat and dress independently after several months of professional therapy and psychological support.

However, he also had to face setbacks during this time, including extensive rehabilitation to learn how to use his hands.

“Our study shows that hand transplant surgery is possible with the careful work of a team of surgeons, transplant specialists, occupational therapists, rehabilitation teams, social workers and psychologists,” says Dr. Sandra Amaral, Children's Hospital of Philadelphia, USA. “After 18 months after the operation, the child was able to carry out daily activities independently. His condition continues to improve with daily therapy and psychosocial support.”

This type of transplant has previously been used for single limbs between identical twins and in adults. Otherwise, during transplantation, adolescents had serious complications, and the patient died shortly after the operation.

The first two-hand transplant in a child took place at the Children's Hospital of Philadelphia in collaboration with Penn Medicine.

The boy was chosen for the operation not by chance. He had already received immune suppression therapy after a kidney transplant, which was required after a sepsis infection that also led to the amputation of his arms and legs at the age of two.

After the amputation, the boy had very limited opportunities to dress, eat, and bathe through the adapted processes of specialized equipment.

The mother of the child was very hopeful for an operation that would allow the child to dress himself, brush his teeth and cut food. And the boy dreamed that one day he would be able to climb a tree and play baseball.

The operation was performed in July 2015 when suitable donor organs were found. The operation was carried out by four medical teams, who simultaneously operated on the hands of the donor and the child.

Six days after the transplant, the boy began daily occupational therapy that included video games, finger development exercises, and daily tasks such as writing and using a knife or fork. He and his mother met regularly with a psychologist and social worker to help the boy get through the post-transplant phase.

A few days after the operation, the boy could already move his fingers. Within six months there was an active recovery of the nerves, and the boy began to regulate the contraction of the muscles of his hands, feel touch, eat and write on his own. By eight months after the operation, he could use scissors and colored pencils, and a year later he could swing a baseball bat.

Brain imaging showed that the boy's brain had developed pathways to control the movement of his hand and carry the sensory signals from his hands back to his brain.

However, not everything was so smooth. There were cases of hand failure. All of them were excluded from immunosuppressants, which did not affect the functioning of the child's hands.

The boy is still taking four types of immunosuppressive drugs, including a steroid that affects bone growth and health. The researchers plan to reduce the use of the boy's immunosuppressive drugs as much as possible.

The child also experienced minor infections and deterioration of the transplanted kidney as a result of increased immunosuppression.

Although the results of the operation are unambiguously positive and the boy is benefiting from the transplant, the operation and post-op period have been difficult for the child and his family.

Doctors explain that care must be taken when evaluating the benefits and harms of hand transplants. Given the need for permanent immunosuppression, all aspects should be carefully considered for children who have not yet been exposed to immunosuppressants before deciding to proceed with surgery. The drugs carry a risk of developing diabetes, cancer, and infections.

Lead Surgeon Dr. L. Scott Levin, Chair of Orthopedic Surgery at the Perelman School of Medicine at the University of Pennsylvania and Director of the Hand Transplant Program at the Children's Hospital of Philadelphia, adds, “We believe this is a hallmark of homotransplants. The case replicates the evolution of solid organ transplantation - the movement of this type of transplant from adults to children."

Mark Cahill is the first person in the UK to have a real human hand transplanted. For 20 years he suffered from gout, his fingers were paralyzed. And now, after an 8-hour operation and 6 months later, the former marine is showing off his new hand with might and main. Not exactly a pleasant sight. It is better for the faint of heart and impressionable people not to watch.

This is how Mark looked during his training for service in the Royal Marines at the age of 17 in 1978

After years of fighting gout, his fingers were paralyzed and it was time for his hand to be amputated. Doctors suggested that he replace his hand with a prosthesis, but Mark chose a real hand, thereby taking a big risk. The operation to amputate the arm and transplant a new one took 8 hours. The doctors had to work hard, because they had to re-sew everything: bone, tendons, nerves, arteries and veins.

Mark is very happy to be able to hold his 4-year-old grandson Thomas by the hand again.

6 months after the operation, Mark may start to develop his hand a little. For example, using the remote control from the TV or the phone is no longer a problem for him.

Or prepare and serve tea to your wife.

It can even scratch the heel, and that is a very useful and irreplaceable function.

The whole set of drugs that Mark needs to take so that his hand is not rejected. The hand functions, even hair and nails grow on it. Mark says he still can't get used to the idea that he has a transplanted arm and that it works.

Mark with his wife, who supported him in difficult times. The hand looks creepy, of course, but doctors assure that over time it will acquire the color of Mark's skin and will be more like part of his body.

Many people with disabilities have a new hope. German doctors introduced to journalists a man who has been living with someone else's hands for a whole year.
A unique transplantation operation returned the joy of a normal life to a disabled person.

Help Karl Merk agreed in one of the clinics in Munich. Operations of such complexity - the transplantation of two arms at once, wholly amputated, that is, just below the shoulder joint - no one has ever done in the world. The patient, among other things, had to be prepared psychologically.
Edgar Biemer, plastic surgeon: “We had a long discussion with him about the fact that, if successful, he would live with someone else’s hands. Many still have prejudices about this. Although, in my opinion, there is nothing like that. We are we do not consider it something abnormal when a patient lives with a heart transplanted from another person."

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Edgar Biemer, plastic surgeon:">!}

Karl Merck did not hesitate for a long time. He told doctors about his dream to ride a motorcycle again someday. Nevertheless, when everything was technically ready for the operation, the transplantologists faced serious difficulties. They could not find a donor for a long time.
Edgar Biemer, plastic surgeon: "It was very difficult to find organs for transplants. It's one thing when you say to the relatives of the deceased, whose body can be used for transplantation:" We need to take the heart, kidneys and liver. "Many relatives agree. And it's quite different when you say: "We need to cut off the hands of the body." There were very great difficulties with this. For a long time, none of the relatives agreed."

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Edgar Biemer, plastic surgeon:">!}

Organs for transplantation were found exactly a year ago. The name of the person with whose hands Karl Merck lives today is still kept secret.
Two teams, a total of 40 doctors, operated on the patient for 15 hours. A week later, the operation was reported to journalists without any details - there was still a risk of rejection, moreover, the operated person could not yet move his arms.

Title="(!LANG:The transplant organs were found exactly one year ago. The name of the person with whose hands Karl Merck lives today is still a secret.
Two teams, a total of 40 doctors, operated on the patient for 15 hours. A week later, the operation was reported to journalists without any details - there was still a risk of rejection, moreover, the operated person could not yet move his arms.">!}

He called the medical staff by pressing the buttons on the remote control with his toes. After 3 months, the doctors announced: the patient may be able to make simple movements with his hands.
All year Karl Merck worked out under the supervision of physiotherapists. He first learned to bend his elbows, then move his wrists, and finally move his fingers. Doctors say that very soon the dream of their patient will come true. He has already ridden a bike.

Title="(!LANG: He called the medical staff by pressing the buttons on the remote control with his toes. After 3 months, the doctors announced: the patient may be able to make simple movements with his hands.
All year Karl Merck worked out under the supervision of physiotherapists. He first learned to bend his elbows, then move his wrists, and finally move his fingers. Doctors say that very soon the dream of their patient will come true. He has already ridden a bike.">!}

Christoph Henke, professor, head of the transplant team: “You know, I think he will soon be able to ride a motorcycle. I remember the day when Karl got on a bicycle for the first time six months ago. Just in case, I settled on the trunk. , my heart, I'll tell you, was beating faster than usual. "Well, I think we're going to collapse or something worse."

Karl Merck got used to someone else's hands pretty quickly.
Karl Merck, farmer (Germany): "My blood flows in them and, therefore, these are my hands. Now I will never part with them."
Karl Merck turned 55 this year. After completing the rehabilitation course, in a few months, he plans to return to the farm.

Modern transplantology is engaged not only in saving lives, but also in improving its quality. Surgeons have learned to transplant limbs, the uterus, the penis, and even the face. However, these complex operations are not always success stories. Time magazine recently published an interview with the first American to have both arms transplanted. The man admitted that he was completely dissatisfied with the results, and would like to amputate the transplants.

In 1999, a resident of Augusta, Georgia, Jeff Kepner (Jeff Kepner) suffered strep sepsis, which began with a banal throat infection. As a result of complications, the then 47-year-old patient had to amputate both arms below the elbow. After a while, he became so accustomed to the prostheses that he could drive a car, go grocery shopping and work in a bookstore.

Ten years after the amputation, in 2009, Kepner learned that the University of Pittsburgh Medical Center was preparing to perform a then-groundbreaking hand transplant. He contacted the surgeons, and in the same year received new hands from a dead donor. In addition, he was put on a light rejection prevention regimen, which included a bone marrow transplant from a donor followed by a small dose of a single immunosuppressive drug.

Doctors warned Kepner that the experimental operation came with certain risks, including rejection. However, the man believed (and, according to him, the surgeons said the same thing) that in the worst case, the transplanted hands would simply have to be removed and returned to the use of prostheses.

Rejection did not come, as well as the restoration of functions. Now, seven years after the operation, Kepner cannot make a single movement with his hands. “I can do absolutely nothing. I sit all day in an armchair and watch TV, ”he complained to the correspondent of the publication.

Jeff Kepner

Photo from the family archive

According to the recipient, he repeatedly turned to the surgeons who operated on him with a request to remove the meaningless grafts, but it turned out to be not so simple. As surgical team leader Andrew Lee explained, if the entire donor tissue is removed, Kepner will not be able to use prostheses - there will be too little left of the forearms. If you partially leave it, you will have to continue suppressing immunity, while the risk of rejection will increase significantly. According to Lee and colleagues, the patient could be helped by smaller additional operations followed by functional rehabilitation, but Kepner himself is not ready for this. He said that he was tired of interference and intends to leave everything as it is.

Hand transplant statistics suggest that Kepner's case is rather an exception. According to Lee, out of 100 such operations performed in Europe and the US, only six cases required amputation of the graft. Review published in 2015 in the journal Plastic & Reconstructive Surgery, gives data on 107 hand transplants in 72 patients (some had both hands transplanted). Of these, 24 operations resulted in subsequent amputation (20 cases) or death (four cases). However, three deaths and eight graft removals were associated with complex transplants (arms and legs or arms and faces), and early experiments in China led to seven more amputations. As a result, when these adjustments are taken into account, the success rate for hand transplants exceeds 83 percent.

In July 2016, British and Indian surgeons successfully performed the first double-hand transplants in their countries. Despite the short time that has passed since the operation, the 57-year-old Briton and the 21-year-old Indian have already begun to show movement in the transplanted limbs.

With the accumulation of experience and the development of surgical techniques, the success rate of transplants should still increase. But be that as it may, any operation is fraught with risk, and even the simplest interventions, albeit very rarely, lead to serious complications, including death. Unfortunately, there is no other way in medicine.