What it’s like to live 10 years with a transplanted hand: ‘I saved my wife from a heart attack’

posted on 6/1/2023 11:06

(credit: BBC)

The first hand transplant was performed in the UK on 27 December 2012. A decade later, we speak with the patient and the surgeon who pioneered the procedure.

“Many patients say that after surgery, the little things matter most to them,” said Simon Kay OBE professor and plastic surgeon. “To be able to brush a daughter’s hair, take money out of her pocket or turn on the faucet to fill a glass of water…”

Or, in Mark Cahill’s case, saving his wife’s life after she had a heart attack.

Cahill’s surgery was performed at Leeds University Hospital, which houses the UK’s Hand Transplant Unit. It is the only place that performs this kind of complex procedure in the country.

The site is considered one of the world’s pioneers in hand transplantation worldwide, an area of ​​medicine that seemed impossible decades ago.

Some of the patients who have passed through the halls of this hospital over the last decade have lost hands or limbs due to accidents. Others due to medical conditions such as sepsis or scleroderma (hardening of the skin and internal organs causing damage to small blood vessels).

The Cahill case

Mark Cahill is a model patient in this medical unit. In 2012, after years of suffering from gout (an inflammatory disease that mainly affects the joints), his right hand became infected enough to require amputation.

It was then that his life intersected with that of the “profe”, as referring to the professor and surgeon Simon Kay, an expression that reflects the closeness created between the two over the years.

“My mom had seen Professor Kay on TV saying he was going to do hand transplants,” Cahill recalls.

“I had a consultation and he told me I was the ideal candidate. I talked to my family and I decided to do it: ‘it has to be better than what I have’. And, indeed, it was.”

Key facts about hand transplantation

• Few families agree to donate the hands of their loved ones
• Hand donation is not an option that can be selected during organ donation registration
• Finding a compatible organ is more complex than finding other organs, as physical appearance and psychological acceptance play key roles in the success of the transplant.
• A year-long patient evaluation is essential and includes psychological and immunological questions
• Recovery and the possibility of new transplants can take from one to three years.
• Hand transplantation is not yet available for children, but this is an area the medical team intends to develop.

Source: Leeds Teaching Hospitals NHS Trust

Cahill was operated on only after intense psychological talks. “They test your psychological state to see if you’re fit,” he said.

The day after Christmas, the phone call he and his family had been waiting for finally came.

“They said: can you come? until after the operation.”

For him, the decision to undergo a transplant was inevitable.

The surgical team contacted surgeons in France who performed the first hand transplant in 1998.

“They put me to sleep and I woke up with a new hand,” says Cahill, who had the transplant the next day.

“I remember waking up in the intensive care unit and the professor came in and said, ‘Let’s take a look.'”

“I could move my fingers a little bit and the teacher said, ‘Don’t do that yet.’ So I thought, ‘Now this works.’ It’s amazing that he moved so fast.”

It was months of physiotherapy. “It was hard at first,” she recalls. “Your nerves take a long time to grow, and without them your movements and sensations are just not there.”

She says the surgery changed her life because it restored what she considers her independence. “Before, I had to ask people to do things for me. Driving, for example, I can drive right-handed, which makes it a lot easier.”

He also ended up saving a life when, in 2016, his wife, Sylvia, had a heart attack. “She was unconscious for 19 minutes and for at least 10 of those I kept her alive with heart compressions using my right hand.”

He says he will always be grateful to the team that followed him. “They’ve been absolutely fantastic.”

outstanding experience

Professor Kay looks back with pride. “Ten years ago, we performed what was considered groundbreaking surgery, making this service affordable, well-coordinated, and one of the top two units in the world,” he said.

“The level of expertise and quality of care provided by this team is outstanding and, of course, our surgeries would not have been possible without the courage and generosity of donors and their families,” he said. “Your contributions have changed lives. It is a privilege to work in this industry.”

However, a decade after the first surgery, hand donation is still not an option in the UK donor registry.

“We need donors,” Cahill said. “It’s a very difficult question for nurses to ask people (authorized family members).”

– This text was published in https://www.bbc.com/portuguese/internacional-64112974