Person who lost both hands in electrical accident gets double-hand transplant

Donor was declared brain dead after suffering from an illness

A 34-year-old boiler operator working in a rice mill in Ballari district, who lost both his hands in an electrical accident a decade ago, has now got a new pair of hands following a complex 14-hour hand-transplant surgery.

The boiler operator — Basavanna Gowda — underwent the surgery at Kochi’s Amrita Hospital. The transplanted hands were donated by the family of a 25-year-old brain dead youth hailing from Kottayam district in Kerala.

The donor — Nevis Sajan Mathew — was pursuing a Masters in Accounting in France. On a visit to the State on a holiday from France, he suffered from an illness and was declared brain dead at a hospital in Kochi on September 25, 2021. His parents — Sajan Mathew and Sherin — readily agreed to donate their son’s vital organs, including his hands. That was when Mr. Gowda’s long wait for a new pair of hands came to an end and the surgery happened.

The recipient had suffered a high-tension electrical burn injury in July 2011 at his workplace in Ballari that badly damaged both his hands, turning them lifeless. Following the accident, he was rushed to a hospital in Ballari and later shifted to Bengaluru, where doctors had to amputate both his arms just below the elbow. After living in desperation for many years, he finally enrolled with the hand-transplantation unit of Amrita Hospital in 2016. His transplant is the ninth hand transplant surgery at this hospital.

A team of surgeons at Amrita hospital, led by Subramania Iyer, Professor, and Chairman for Centre for Plastic and Reconstructive Surgery.

Addressing reporters here on Wednesday, Mohit Sharma, Professor, and Head, Centre for Plastic and Reconstructive Surgery at the hospital, said the transplants were done in the upper third of the recipient’s forearms.

“It was a very complicated surgery because, at this level of limb transplantation, only one-third of the natural length of arm muscles are present in the recipient. We had to bring the rest of the muscles from the limbs of the donor and overlap those over the existing muscles of the recipient’s hands. Even the union of the two bones was complicated as we had to bend the joining plates exactly to the shape of the bones,” he explained.

“The most important thing was to reduce the ischemia time, which is the period between the cold perfusion of the donor hands and their warming up later by restoring the blood supply. This was done by rapidly joining the arteries and veins to restore blood circulation and using a new oxygen-carrier Hemo2 Life. Later, all the nerves and muscles were repaired, followed by skin closure in the end,” Dr Sharma said.

Dr. Iyer said the patient’s surgery was highly successful and he was discharged from the hospital after a few weeks. “He now needs to undergo a daily routine of active and passive physiotherapy, including muscle stretching. He will also have to take sessions of nerve stimulation to improve the nerve growth and quality of function of the new hands. Thereafter, he will have to undertake muscle strengthening exercises, followed by occupational therapy and the application of various types of functional splints to facilitate his daily activities,” he said.

“This will continue for at least one year to ensure a good functional outcome. He will be able to actively move his fingers only after a few months. The patient also has to take lifelong medications to prevent the rejection of the transplanted hands,” he said.

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