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Thursday, 17 August, 2000, 11:14 GMT 12:14 UK
Hand transplant 'a success'
World's first double hand transplant
World's first double hand transplant was in January
Doctors in the US have reported that the world's second attempted hand transplant has been a success.

Doctors at the Jewish Hospital of Louisville in Kentucky carried out the operation on a 38-year-old man in January 1999.

Matt Scott received a transplanted left hand from a 58-year-old man who had died. Mr Scott had lost his hand in a fireworks accident at the age of 24.

Doctors have been able to reattach severed limbs since 1964 but transplanting the limbs of a dead person to one who is alive is a relatively new procedure.

Writing in the New England Journal of Medicine, the doctors in Kentucky hailed their operation as a success.

Rejection risk

Mr Scott can use the hand to write, turn the pages of a newspaper, throw a baseball and tie shoelaces.

He can also feel changes in temperature, pressure and pain.

He was unable to perform any of these activities with a prosthesis before the operation.

The US doctors used various drugs to stop Mr Scott's body from rejecting the transplanted hand.

The hand is at risk of being rejected because the body's immune system identifies it as being new and foreign and tries to attack it.

Mr Scott's body tried to reject the transplanted hand on three separate occasions.

However, the drugs that doctors use to suppress the immune system can have potentially serious risks.


Hand transplants are not going to be very common

Mr Nadey Hakim, St Mary's Hospital, London

Dr Jon Jones, who led the surgical team that carried out the operation, said existing drugs could be used to fight off rejection.

"Early success at hand transplantation can be achieved with the use of currently available immuno-suppressive drugs," he said.

Dr James Hendron, a surgeon at Harvard Medical School, said better anti-rejection drugs would be needed if hand transplants were to become more common.

He suggested that the ideal candidate for a hand transplant would be a patient who was "already taking immuno-suppressive drugs for a life-threatening problem".

Mr Nadey Hakim, a surgeon at St Mary's Hospital in London who has taken part in a hand transplant operation in France, said any patient who undergoes the procedure would experience rejection.

"There are no drugs for any transplant which are going to be 100% effective. All patients will eventually have some rejection and nobody will be completely immune from rejection."

Mr Hakim said he did not believe that hand transplants would become very common.

"It is not going to be very common, like a kidney, lung or heart transplant.

"Arms are not vital organs. The majority of patients are happy to carry on a normal life without having a transplant."

The surgeon is planning to perform a double hand transplant on a British patient.

The doctors have ruled out a single hand transplant on the grounds that any operation would be of more benefit to a person without any hands.

World first

In May, the New Zealand man who received the world's first hand transplant underwent emergency medical treatment.

Clint Hallam, 49, has received treatment for rejecting the hand but, according to doctors, the patient is continuing to do well.

And the world's first double hand transplant was carried out in January by a team of international surgeons in France.

The 33-year-old patient - a man from Rochefort on the west coast of France - had both arms amputated below the elbow in 1996 following an accident when an amateur rocket exploded in his hands.

A 50-strong team of doctors and medical technicians - including 18 surgeons - were involved in preparing for the groundbreaking operation.

It is still too early for doctors to tell if the operation was a success.

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See also:

02 May 00 | Asia-Pacific
First hand transplant in doubt
25 Sep 98 | Health
'World's first hand transplant'
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