A 28-year-old brain dead man's hands were transported to Mumbai from Gujarat's Ahmedabad to be transplanted to a man who lost his hand in a freak accident. Prathamesh Tawde (22) lost his left hand and three fingers of his right hand in an accident at a tyre factory in Mumbai in April last year. Prathamesh’s hands had gotten trapped in a machine and he sustained burns over his forearms and thighs due to hot rubber. His left hand was amputated at distal forearm level and he lost three fingers of his right hand in the accident.
After undergoing primary treatment at a hospital in suburban Bhandup, the teen was registered for a hand transplant two months ago and was on the waiting list. On February 9, the Tawde family received a call from the hospital that a pair of limbs were being donated in Ahmedabad, where a man who met with a motorcycle accident, was announced brain dead and his family had decided to donate his hands and internal organs. “We had to relocate from Vaibhavwadi (Sindhudurg district) to Diva (a suburb in Thane) for his treatment. Since then (April 2021), we have been here,” Prathamesh’s sister Shraddha (21) said. Prathamesh came across a video on hand transplant surgery on Facebook and inquired about it in the comments, following which a hospital got in touch with the family, she said.
The hands of the accident victim were flown from Ahmedabad to Mumbai in a charter flight on February 10. The organ was carefully preserved in special solutions and packed on ice for transportation, it was stated. A large team of doctors comprising surgeons from plastic, hand, microvascular orthopaedic departments and anaesthesiologists participated in the complex 13-hour surgery, it was stated. “The surgery was very challenging,” said Nilesh Satbhai, head of the department, senior consultant, Plastic, Hand and Reconstructive microsurgery & Transplant Surgery at Global Hospital, Parel. The recipient limb on the left side was severely scarred and damaged. Due to primary crush a partial transplant was done on the right side.
“We transplanted only the index, middle and ring fingers to the hand, without disturbing or damaging the patient's original thumb and little finger. This is more difficult to do than a standard forearm level transplant,” he said. In hand transplant, the bones are fixed first, followed by repair of the blood vessels. This is followed by the repair of the muscles, tendons and nerves. The skin is then adjusted to cover all the wounds and give it a proper shape. A crossmatch between the donor and the recipient is a crucial decision maker in the process of hand transplants, Dr Satbhai explained. "In hand transplants, we match the blood groups and the HLA (human leukocyte antigen) typing. We ensure that the crossmatch is negative, before proceeding with the transplant," he said. The patient is doing well now. His right hand will have a quicker recovery, while it will take him nine months to achieve good movement on his left hand, Dr Satbhai said.
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