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Summer 2011

UCLA’s Hand Transplant Program

Launches with Successful First Procedure

06/29/2011

VS-Summer11-Hand Transplant ProgramUCLA launched the first hand transplant program in the western United States in February, and in March it performed its first operation — a 14½-hour procedure to give a new right hand to a 26-year-old woman from Northern California who lost hers in a traffic accident in 2006.

It was the 13th hand transplant performed in the U.S. The complex procedure was performed by Kodi Azari, M.D., surgical director of the UCLA Hand Transplant Program, and a 19-member surgical team that included nine surgeons, three anesthesiologists, four nurses, a transplant coordinator, an organ preservationist and an O.R. technician.

“We’ve been a major transplant center for more than 25 years, and this is a new frontier in transplantation that we thought we should really explore,” says Sue McDiarmid, M.D., medical director for the program. “We have so much expertise here in the surgical techniques and in transplant medicine. We’ve brought the two sides together and formed a fantastic team.”

More than a month after the procedure, the patient is doing well and progressing with her rehabilitation, and she is able to grasp small, light objects with her new hand. It takes many months of rehabilitation following the surgery to regain the fullest possible use of the new hand; it can take up to 18 months or more to recover sensation.

Hand transplantation is considered experimental, and the operations that will be done at UCLA are part of a clinical trial “not only to offer the proof of principle of the surgical procedures, but also to study the safety and effectiveness of the immunosuppressive drugs, as well as the return of function of the transplanted hand,” Dr. McDiarmid says.

Hand transplantation differs significantly from other transplant procedures because, unlike a heart or liver, for example, a hand is made up of different kinds of tissues — bone, nerve, tendon, muscle, skin and blood vessels — and each has its own characteristics for healing and regeneration.

And unlike other types of transplantation, a hand transplant is not lifesaving. Many people who have lost a limb are able to get along fine with a prosthetic hand. But others, like UCLA’s first patient, find that a prosthetic limb is too uncomfortable or cumbersome. However, potential patients must be fully informed and aware of the complications of lifelong immunosuppression and have to weigh these risks against their perception of how a new hand will enhance their life.

“This operation is not for everyone,” Dr. Azari says. “It is designed for the person who has recovered from the initial trauma of the amputation, both physically and psychologically, and has tried a prosthetic device for at least six months.”

For more information about the UCLA Hand Transplant Program and to view videos about the program and UCLA’s first hand transplant surgery, go to: www.handtransplant.ucla.edu

Transplantation Criteria

To be considered as a candidate for the UCLA Hand Transplant Program:

  • The patient must be between 18 and 60 years of age
  • The amputation must have been at the wrist or at the forearm level
  • The patient must have no serious infections, including hepatitis B or C, or HIV
  • The amputation was not due to a birth defect or cancer
  • The patient is otherwise in good general health
  • The patient will commit to extensive rehabilitation, will adhere to an immunosuppressant medication regimen and will participate in follow-ups with the transplant center




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