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Friday, September 25, 1998 Published at 18:52 GMT 19:52 UK


Health

'World's first hand transplant'

The complex elements involved in the operation


Professor Earl Owen explains how the team performed the operation
Surgeons in France say they have carried out the world's first hand transplant.

The hand and forearm came from an anonymous dead donor and was grafted onto the right arm of 45-year-old Clint Hallam, an Australian whose own hand was amputated 14 years ago after an accident.

An international team of scientists were assembled at the Edouard Herriot Hospital in the city of Lyons to perform the procedure.

It lasted from 10 in the morning on Wednesday until almost midnight - more than 13 hours.

A statement from the hospital said all the arteries, veins, nerves, tendons, muscles and skin of the new hand were attached to the arm, as well as two bones from the forearm.

Nerve connection

The team, headed by Professor Earl Owen from the Centre for Microsurgery in Sydney and Jean-Michel Dubernard from the Lyon hospital, must now wait several months before they know whether the nerves in the arm have knitted together.

The predominantly Australian team has pioneered many of the techniques for re-attaching severed arms and fingers. Professor Owen said a transplant operation would have been done many years ago if the right drug technology had also been available.

"It would have been done by us if there had been the correct immuno-suppressants - the drugs required to stop the rejection of somebody else's tissue if it's grafted onto you," he said.

"We've had to wait 30 years before the immuno-suppressants became so clever that this doesn't become an operation that will hurt the patient."

Donor availability

Professor Owen said their first task was to find a hand and forearm from a donor with the same blood-type and tissue-type as Mr Hallam. This meant travelling to France where donor law means far more organs and limbs become available to surgeons.

"In France, it is assumed - and there is a government regulation - that everybody is a donor unless they protest," he said. "So there are many more donors available and more choice."

The bones were joined together first "for stability". Then the blood supply was connected via the major arteries and veins, followed by the tendons, muscles and nerves. The skin was the last tissue connection.

Hand movement

Professor Owen said it would take at least three to four weeks before the patient would be allowed to attempt to move the hand.

If the procedure works, it will bring hope to millions of people who have suffered accidents at work or in the home, victims of war and landmines, and those with congenital deformities.

No details of the donor have been given, but it is known that organs were used for other transplanting purposes.

Another group of surgeons, based in the US state of Kentucky, announced in July that they were planning to carry out an identical operation by the end of the year.



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