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How Useful Will the New Hand Be?

 

As the patient continues to progress through physical therapy, his new hand will gradually increase in functionality and sensation. The stiffness in his fingers and wrist should all but disappear by 100 days after the operation, at which point the color, temperature, and texture of the graft should also be satisfactory. By six months the hand should have increased in sensation and movement, and even more so by one year. But the transplanted hand will almost certainly never return to full functionality and sensory levels; to put it in the words of one physician from the Louisville team that performed the first U.S. hand transplant, the patient will likely “have difficulty with buttons, perhaps not be able to pick up a dime.”

Matthew Scott, nation's first successful hand transplant recipient, demonstrates his ability to write with his transplanted hand during his two-year exam at Jewish Hospital, Louisville, KY.

(Photo courtesy of Jewish Hospital; Kleinert, Kutz and Associates Hand Care Center; and University of Louisville [caption: www.handtransplant.org])

The prospect of hand transplantation is a wonderful thing, but a grafted hand will never function at the level of one’s natural hand, nor will it be capable of experiencing fine sensation throughout. Nevertheless, the experiences of recipients thus far have been very encouraging. The Lyon group that performed the world’s first successful hand transplant has observed that sensorimotor recovery in transplants is actually faster in allotransplantation than in autoreconstruction because the immunosuppressant tacrolimus accelerates axonal regeneration. The personal experiences of some of the few recipients also testifies to the promise that this experimental procedure holds for those in need of a hand.

Jerry Fisher, the nation's second recipient of a hand transplant, demonstrates how he can now tie his shoes with two hands.

(Photo courtesy of Jewish Hospital; Kleinert, Kutz and Associates Hand Care Center; and University of Louisville [caption: www.handtransplant.org])

Encouraging news for hand transplantation
• Gerald Fisher, the second of the Louisville recipients, returned to work hanging gutters just two months after his operation
• According to the Lyon team, the world’s first double-hand transplant recipient is able to shave and take care of other personal hygiene tasks that he was unable to do before his transplant
• Italian surgeons said that 22 years after one patient’s hand was severed, the transplant has afforded nearly the same sense of touch in his transplanted hand as the other
(Encouraging news taken from www.txmiami2002.com)

Matt Scott throws the ceremonial pitch at the Phillies' opening game on April 12, 1999. Photo by Brad Bower.

(Photo courtesy of Jewish Hospital; Kleinert, Kutz and Associates Hand Care Center; and University of Louisville [caption: www.handtransplant.org])