Mumbai prepared for its first hand transplant late Thursday with 24-year-old Monika More, who lost her hands in a train accident in 2014, scheduled to undergo the surgery at Global hospital around 2 am on Friday.
Two hands, donated by a 30-year-old man, who was declared brain dead at Global hospital’s Chennai branch on Thursday, were being brought to Mumbai.
Doctors in Mumbai said that as the man’s family agreed to donate both his hands, they were retrieved late Thursday in the Chennai hospital and flown to Mumbai in a chartered flight. The flight was scheduled to land by 12.30 am, and doctors planned to start the surgery by 2 am.
“She got a call, and was admitted today. Surgery will begin late night,” said Ganesh More, Monika’s cousin.
“It is a complicated procedure, and we are making all preparations,” plastic surgeon Dr Nilesh Satbhai said, hours before the surgery.
In 2014, Monika had lost her hands when she attempted to board a moving train at Ghatkopar station and slipped through the gaps onto the tracks. She had to undergo amputation from above her elbows at KEM hospital. She was subsequently fitted with sponsored prosthetic limbs but could not normally function with them.
The Kurla resident registered herself for a hand transplant procedure in September 2018 with Global hospital after hearing about Pune-based Shreya Siddhagaonkar who underwent a similar surgery at Kochi-based Amrita Institute of Medical Sciences (AIMS) in 2017.
Monika’s father Ashok More, who suffers from a kidney ailment, had been gathering funds for her surgery – set to cost Rs 25 lakh – since then.
The first successful hand transplant in India was conducted by AIMS on Kochi native and train accident victim Manu on January 13, 2015. In 2018, Pune’s Command hospital attempted western India’s first double hand transplant on a serving soldier, but the transplant failed due to hyper acute rejection.
“We are hopeful that this one will work. Transtan coordinated the donor matching and transfer of the organ. Since it was one hospital chain, the wait list could be quickly checked and compatibility tests performed,” an official from Regional Organ and Tissue Transplant Organisation (ROTTO) said. Transtan is a Chennai-based body that handles cadaver organ donation.
A hand transplant surgery can go on for 12 to 14 hours, as a team of anaesthetist, plastic surgeons and transplant surgeons, together fuse the bone, then two arteries, six veins, and several tendon muscles. Upper arm transplants are more challenging than transplants at the wrist due to the complexity involved in accurately identifying and connecting various nerves, tendons and arteries, said doctors. Moreover, the further the transplant is done from the wrist, the more it can take for rehabilitation.
In this case, as Monika met with the accident in 2014, doctors suspect her nerves have lost sensations and rehabilitation will take longer, perhaps close to a year. Also, male hands would be transplanted into a female body, which takes longer for the recipient’s body to adjust. Siddhagaonkar was also transplanted with male hands, which in two years lightened to match her skin tone and even became more feminine.
The Global hospital in Mumbai has two more amputees registered with it for a hand transplant – Malaysian national Gobi Mayelvahanam (30) and Punjab resident Kulvir Singh. Dr Astrid Lobo, heading ROTTO, said the waiting list for hand transplant is currently in single digit in Maharashtra. Apart from Global hospital, KEM is registered to perform hand transplant in the city.
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