Hand Transplant Completed For First Time In UK

A 51-year-old man has become the first person in the UK to have a hand transplant.

Mark Cahill said he was "well happy" after an eight-hour operation by doctors at Leeds General Infirmary on December 27.

He said he was now looking forward to being able to "cut my food up, button my shirts, fasten a pair of shoelaces, and (...) hold my grandson's hand."

But the op was immediately lambasted by one of the UK's most renowned surgeons, who suggested that Mr Cahill could be left with a "dead hand at the end of an arm".

Lord Robert Winston said even when nerves were all carefully joined up "these transplanted hands were very limited and most often caused huge inconvenience".

However, doctors in Leeds said a new technique was used during the latest surgery.

It involved Mr Cahill having his non-functioning right hand removed during the same operation as the donor hand was transplanted.

This procedure allowed very accurate restoration of nerve structures and is believed to be the first time this approach has been used, surgeons said.

Consultant plastic surgeon Professor Simon Kay, who led the surgical team, said: "This operation is the culmination of a great deal of planning and preparation over the last two years by a team including plastic surgery, transplant medicine and surgery, immunology, psychology, rehabilitation medicine, pharmacy and many other disciplines.

"The team was on standby from the end of November awaiting a suitable donor limb, and the call came just after Christmas.

"It was extremely challenging to be the first team in the UK to carry out such a procedure.

"Any organ donation brings something positive from tragedy and I would like to acknowledge the tremendous gift the family of the donor have made at such a distressing time.

"It is still early days but indications are good and the patient is making good progress."

In an interview with ITV's Daybreak, Mr Cahill, from Greetland, West Yorkshire, said: "Eight o'clock on Boxing Day night we got a phone call saying we may have a donor.

"As you can imagine, the day after Christmas it was quite a shock. I'm getting slight movement now, my feeling has just started coming back, but everything's looking very, very good.

"Long term I won't have 100% use of it, but obviously I'm going to have a lot more use than I had with the existing hand.

"I think I've dealt with it pretty well. The only thing you can't do is know what is going to happen after the operation, and as it has turned out it is brilliant. I'm well happy.

"Hopefully I will be able to get back to work for a start, that's a major difference.

"For a start I might be able to cut my food up, button my shirts, fasten a pair of shoelaces, and mainly I'll be able to hold my grandson's hand."

He told the BBC: "It just does not feel like somebody else's hand. As I look at it and move it, it just feels like my hand."

Leeds Teaching Hospitals announced in late 2011 that it was starting to look for candidates for hand or arm transplants.

Potential patients are put through a series of health checks and psychological assessments to ensure they have carefully considered the implications.

Mr Cahill, who lost the use of his right hand due to severe gout, was one of two potential candidates when a donated limb became available.

He was selected because he was the best tissue match.

The team has been working closely with NHS Blood and Transplant (NHSBT) and also colleagues in Lyon, France, where hand transplants were pioneered in 1998.

The first-ever recipient in France was New Zealander Clint Hallam, who later had his new hand removed.

He lost his original hand in a circular saw accident in prison in 1984.

He eventually decided he could not live with his new hand, which was taken from a motorcyclist who died in an accident, because he said it felt like a dead man's hand.

Doctors indicated Mr Hallam had not stuck to the correct drugs and exercise regime.

His experience cast doubt on the whole procedure although surgeons have pointed out that a number of hand transplants have been successfully completed in the US.

Mr Cahill's operation was dismissed by Lord Winston, a surgeon who helped to pioneer hand transplant surgery in the 1970s.

He said: "History repeats itself. The first hand transplant that I was involved with was done by Willy Boeckx and myself in 1975 in Leuven when I was working there (not 1998) when we were pioneering microsurgery. 

"Even then, I am not sure whether it was the first, probably not.

"What is clear is that since that time there have a number of hand transplants (I followed one in my TV series Superhuman in 1999 - 2000) which showed that, even when nerves and vessels and tendons were all carefully joined up under a microscope, these transplanted hands were very limited and most often caused huge inconvenience to the recipient because of lack of function - essentially a largely 'dead hand' at the end of an arm.

"I really can't see this is much of a breakthrough given that a donor hand has extra inconvenience and complications - not least of which is the serious risk of rejection in spite of the need to take powerful and risky immunosuppressive drugs."

A spokeswoman for NHSBT said it was aware that a limb transplant had taken place.

She said: "Our thoughts are with the family of the donor at this time. Without their agreement for donation, this operation would not have taken place.

"We also send our best wishes to the recipient for a healthy recovery.

"There are currently 10,000 people waiting for a transplant in the UK. NHSBT urges everyone to sign up to the NHS Organ Donor Register and to tell their families of their wishes."