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Ten years ago, Jeff Kepner lost both his hands and feet to a bacterial infection. Today, he is recovering from the first US double hand transplant surgery. Soon, he’ll be able to hold his daughter’s hand for the first time in a decade.

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Kepner's surgery underway. Photo courtesy of University of Pittsburgh Medical Center

Kepner, a 57-year-old pastry chef living in Georgia, got his new hands after a nine-hour surgery at the University of Pittsburgh Medical Center. He is still recovering, but has strong circulation in both hands and has showed no signs of organ rejection. The success of his surgery is in part due to a unique new procedure to improve an organ’s chance of being accepted by the body.

Whenever an organ transplant takes place, doctors have to suppress the recipient’s immune system so that it does not reject the new organ outright. This suppression requires toxic drugs that can increase the chances of infection, cancer, diabetes, or other complications. But in the past decade, an innovative procedure has been used to reduce the need for such drugs while still minimizing the likelihood of rejection. Used during Kepner’s transplant, the procedure transplants stems cells from bone marrow into the donated organs, helping the immune system more quickly recognize the hands as part of the body.

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hand_transplantDid you know that for ten years now it has been possible to transplant a donated hand (or a pair of them) to a person who has lost one or both of their hands?  Earlier the hub reported on the amazing fact that re-attaching severed limbs such as arms and legs has been commonplace for decades.   Today we reveal that not only is hand re-attachment possible, but in the last ten years hand transplantation has seen significant success in roughly 40 patients worldwide.

The source for most of this story comes from handtransplant.com, a website showcasing the success Jewish Hospital and its partners have achieved with hand transplants since they pioneered the world’s first long term hand transplant in January 1999.

As with all organ transplants (hearts, livers, and even hands) one of the greatest challenges a patient faces is organ rejection, a process where the immune system attacks the new organ as a foreign invader. For decades now we have had the medical means to fight organ rejection, although the treatment is error prone, requires the patient to stick to a rigourous regiment of drugs, and is plagued with several negative side effects.

Even assuming the problem of organ rejection can be contained, the problem of properly attaching the tiny veins, arteries, and other parts of the body to the new organ is quite a challenge.  New advances in microsurgery have greatly enhanced our ability to overcome this challenge, paving the way for the hand transplants of today.  Here is a crude outline of the procedure:

The surgeon will progress with tissue repair in the following order: bone fixation, tendon repair, artery repair, nerve repair, then vein repair. The surgery can last from 12-16 hours. In comparison, a typical heart transplant takes six to eight hours and a liver transplant, eight to twelve hours. Typical post-operative complications include blockage of the blood supply, infections and rejection.

Want to learn more?  Check out this detailed video of one man’s experience with a double hand transplant:

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Image: source