Double Hand Transplantation
In 2016 the first hand transplant in the UK was performed at Leeds General Infirmary. Immediately thereafter the commissioning arrangements within the NHS changed and it was necessary to make application for this procedure to be included in Highly Specialised Surgery Commissioning. This application to NHS England was long and thorough but in late 2015 the principle was accepted. Leeds then applied for and was granted the contract for the provision of this service in April of 2016.
In July 2016 Leeds undertook a double hand transplant on a patient from Yorkshire who had lost all eight fingers at the base of metacarpal level, and who was unsuitable for toe transfer reconstruction. It should be noted that the excellent primary surgery carried out in the expectation of future transplantation by the team in Sheffield under Mark Hobson greatly contributed to the ability to undertake transplantation.
The surgery was a complex and orchestrated procedure with organisation and retrieval spanning 36 hours, the surgery itself taking some 10 hours. Eight consultant surgeons participated at a weekend voluntarily, as did a huge specialist support team.
Both patients to date are doing well and we will be presenting early results at meetings this year. The first case was unique in that the native hand was removed at the same time as the transplant (a first in this field) whilst the second case is to our knowledge the first case of a bilateral transplant at that complex level. The details of the decision making in these cases will be presented elsewhere.
The organisation and support for transplantation is complex and demanding (and mostly hidden!) but we believe in its value and utility, and we aim to examine this belief in a cohort of properly indicated well-executed procedures within an NHS institution to allow prospective analysis and understanding. We have three further cases at the current time awaiting transplantation (with two others in the process of evaluation) and invite any enquiries on behalf of your patients to come through either the normal channels or by direct discussion with me on firstname.lastname@example.org