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Briton trades old hand for new

- Transplant feat

London, Jan. 5: A 51-year-old man has had his right hand, diseased by severe gout, surgically cut off and a replacement from a deceased donor stitched on successfully in what is being hailed in Britain as a medical breakthrough.

The trickiest part of the eight-hour operation performed on Mark Cahill, a former pub landlord, was to join the nerve endings. But Cahill said he could move his fingers and hoped eventually to “cut my food up, button my shirts, fasten a pair of shoelaces, and mainly I’ll be able to hold my grandson’s hand”.

Several hand transplants have been carried out in France and in the US. But in most cases, a transplant was required because the patient had lost a hand in an accident. In Cahill’s case, his own hand was surgically removed and replaced with the donor’s.

Cahill and his 47-year-old wife Sylvia, who have a daughter, are now a very happy couple. At 8pm on Boxing Day, Cahill received an urgent phone call at his West Yorkshire home in Greetland.

He was summoned to the Leeds General Infirmary with the news that a possible donor had been found. A second patient was also asked to attend but it was bad luck for him — tests showed that Cahill would provide a better tissue match with the donor hand.

After the operation, Cahill was well enough to tell TV stations: “I’m getting slight movement now, my feeling has just started coming back, but everything’s looking very, very good. Long term, I won’t have 100 per cent use of it, but obviously I’m going to have a lot more use than I had with the existing hand.”

The operation, done by a team led by consultant plastic surgeon Simon Kay, used a new technique that allowed very accurate restoration of nerve structures and is believed to be the first time this approach has been used.

The team in Liverpool has been working with French colleagues in Lyon, where hand transplants were pioneered in 1998. The first recipient was a New Zealander, Clint Hallam, who lost his right hand in a circular saw accident in prison in 1984.

But psychologically he felt he “could not live with someone else’s hand”. Doctors blamed Hallam for not taking his medicines but he said he felt he was attached to a dead man’s hand. Ultimately, he preferred to have the transplant surgically removed.

This is a science that is progressing fast. The day is not far off when face transplants will become as routine as heart transplants.

In 2005, the first partial face transplant was carried out in Amiens, France. Isabelle Dinoire, a 38-year-old woman mauled by her dog, was given a new nose, chin and lips.

While face transplants will be invaluable for those disfigured in accidents or violence -— Indian women who have had acid thrown on their faces by jilted lovers, for example — they may also provide new identities to criminals.

Doctors say that when a new face is switched on, the recipient does not look like the donor or his or her own self but something different — the look depends on how the new face stretches over the contours of the underlying skull.

 
 
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