Asia’s first upper-arm double hand transplant
October 16, 2017 – Kochi, Kerala, India
Shreya Siddanagowda looked where her hands used to be to find a rarely successful replacement. The 19-year-old woman had lost both her hands in a road accident. As a chemical engineering student at Manipal Institute of Technology in Karnataka, many questions arose about her future.
But now, the hands of a young man named Sachin have been surgically placed there by a team at Amrita Hospital. Sachin, at just 20, was declared brain dead after suffering a head injury in a motorcycle accident. It was his parents wish that his hands and other organs be donated for transplant.
Even though Shreya has received the hands of a male donor, she felt them to be great when she first saw them.
“Hopefully, in the next couple of years, I will be able to lead a near normal and happy life,” she said. “I want to continue my studies and fulfill all my dreams that I had before the accident. I thank the donor Sachin’s family and doctors at Amrita Hospital for giving my life back.”
Upper-arm transplants are very challenging. In fact, only nine such cases exist in the world and this was the first in India as well as all of Asia. For Amrita Hospital, it is also the fourth successful hand transplant surgery in the last three years.
“The complexity of upper arm transplants is involved in accurately identifying and connecting various nerves, muscles, tendons and arteries,” explained Dr. Subramania Iyer with the Plastic & Reconstructive Surgery Unit at Amrita Hospital. He led a team of 20 surgeons and a 16-member anesthetic team for Shreya’s surgery, which lasted 13 hours.
“Rehabilitation is also much more difficult,” he added. “The patient bears the weight of the transplanted hands at the upper arm. In Shreya’s case, both transplants were done at the middle of the upper arm.”
Shreya is the only daughter of Suma Nuggihalli and Fakirgowda Siddnagowder, a senior manager at Tata Motors in Pune. In September 2016, while returning by road from Pune to her college near Mangalore, the bus she was travelling in overturned and crushed her hands. She was rushed to a hospital where both her arms had to be amputated at the elbow.
“My whole world collapsed and I couldn’t believe what had happened,” Shreya explains. “However, I recovered emotionally in a few weeks because of the loving support of my family and close friends, even though momentary lapses into depression continued.
“When I was told by my mother that hand transplants were now being conducted in India, I got great strength and hope, and my disability began to look temporary. I felt that one day, I will again be able to lead a near-normal life with a transplant.”
Shreya’s body has accepted the transplanted hands and is showing good signs of recovery. She has been discharged from the hospital and put on an intensive physiotherapy and rehabilitation program.
“Shreya is currently undergoing a regime of movements across her arms. We expect that she will regain 85% of hand function in the next one-and-a-half years,” said Dr Mohit Sharma, who along with Dr. Ravishankaran, played lead roles in the surgery.
Amrita Hospital created medical history in January 2015 by carrying out India’s first hand transplant on a 30-year-old patient, Manu TR. This feat was followed by another hand transplant surgery in April 2015 on a young Afghan soldier.
Both these transplants were at the wrist level. In July 2016, the hospital conducted India’s first double transplant at the elbow level. All these patients are doing well, and two of them have already become employed.