WROCLAW, Poland (Reuters) — Polish doctors have succeeded in transplanting a hand from a dead man to a 32-year-old man who was born without a hand, proving that transplants in cases of congenital deficiencies are also possible.
Hand transplants have been improving since 1999, but surgeries have normally been performed in situations in which the patient had lost the limb in an accident.
Doctors have always feared that the brain of a person born without a limb and living a whole life without it would not be able to control a transplanted body part, according to experts at the at the University Hospital of Wroclaw.
The very first attempts to transplant a limb to a person with congenital deficiency took place in Kuala Lumpur and Toronto, but in both cases surgeries were performed after Siamese twin separations in which one couldn’t make it and its body parts were donated to save the other one, and as the donor and recipient were twins, they genetically matched.
Dr. Adam Domanasiewicz’s team claims that the main difference to those early transplants is the genetical difference as well as the age of the patients, as they were always infants.
“This problem was not solved by the transplantation apart from this two cases of Pathmanatan in Kuala Lumpur and Ronald Zuker in Toronto but there were conjoined twins, this is completely another surgical problem and immunological problem. This is a pure allotransplantation to adult man, 32 years living without the extremity.” Domanasiewicz told Reuters at the hospital.
In 2009, he performed a successful limb transplant on a man who lost a hand at the age of one and a half but then received one after 29 years, not remembering how to use it.
Surprisingly he started using it in a very short time giving doctors hope that transplants in cases of congenital deficiencies were also possible.
Piotr K, from the town of Zamosc, was born without a hand but has already started moving his new fingers, almost immediately after the tube was removed.
“I’m slowly getting better,” he told Reuters as he recovered at hospital.
“The surgery was difficult, it took 13 hours so my organism was really exhausted,” he added.
One of big challenges for Dr. Domanasiewicz was to restore undeveloped nerves and arteries that had never been used before.
“We have to support it or suspend it with the tissue taken from the donor. So it’s like multi-level amputation, each level represents different structures. So it means that practically the nerves are underdeveloped, the arteries are very very narrow and atrophic and they finish on unexpected levels,” he said.
Asked about what challenges the future will bring in this area, he said:
“Next step would be a person with double congenital absence or aplasia or hypoplasia of the extremities.”
