Thursday, August 26, 2010

Double Hand Transplant on Twitter

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active.
Louisville surgeons at The Jewish Hospital Hand Care Center recently performed the 3rd double hand transplant done in the United States.  It is the first to be live tweeted.
The procedure began around 7 p.m. on Tuesday, August 24, and finished late Wednesday afternoon, August 25.  Lead surgeon, Warren C. Breidenbach, M.D, with Kleinert Kutz & Associates, and his team of surgeons focused on the surgery while senior hand fellow Christiana Savvidou, M.D. used a laptop just outside the operating room to document the surgery as it takes place.
This bilateral transplant is the third double hand transplant to be done in the United States.  The first two double hand transplants were done at the University of Pittsburgh Medical Center, the first in May 2009 and the second in February 2010.  Louisville doctors performed the nation's first five single hand transplants.
Savvidou used the tweeter account @jewishhospital ( and the hashtag #handtx.
Here are some of the tweets which are a good representation of how the surgery progresses and how much time it takes.

1st tweet ~ 7 pm ET, shortly before start of surgery
Want to know how a hand transplant is done? This is your chance- we are live tweeting a double hand transplant 2day starting @ 7pm! #handtx
approx 2 hrs later
The recipient’s right hand is fully prepped and awaiting the transplantation of the donor limb. #handtx
Education of terms: “prepped” = hand is being scraped & sterile dressing. “Started” = skin has been cut and surgery begun. #handtx
approx 4 hrs after start
Continuing donor and recipient dissection tendon identification and nerve identification in both recipient hands. Going smoothly. #handtx
approx 5 hrs after start
Removal of non-functioning hand tissue in preparation for donor limb attachment. #handtx
Both donor hands are on the table. Preparing for bone work - bone fixation at forearm of right recipient wrist. #handtx
@stacyluvsyah The bones are reattached with plates and screws similar to how a broken bone may be repaired. #handtx
approx 6 hrs after start
Bone fixation completed successfully in both hands. #handtx
Surgeons are now preparing the arteries. This will be the most important part of the operation. #handtx
approx 7 hrs after start
The connecting of the donor and recipient vessels (arteries and veins) is progressing very well in both hands. #handtx
approx 8 hrs after start
The hand replantation is progressing well. Surgeons are joining the tendons. #handtx
approx 10 hrs after start
Both hands are now vascularized and we are approximately 3/4 of the way complete. All is progressing well. #handtx
approx 11 hrs after start
Tendon suturing nearing completion. Nerve repair to follow. This includes suturing nerves of each finger from donor to recipient. #handtx
approx 12 hrs after start

Due to the number of nerves and tendons, this current stage could take a while…update coming when we near completion of this stage #handtx
approx 13 hrs after start
Nerve repairs on the left hand are now complete. #handtx
approx 14 hrs after start
The left hand is currently approximately 2/3 closed and final work on veins is occurring. #handtx
approx 16 hrs after start

Finishing right hand nerve repair. Due to new technique, this patient should have better feeling & motion than previous recipients #handtx
The left hand is currently being sewn shut. #handtx
approx 17 hrs after start
The left hand is now fully wrapped in surgical gauze and cotton padding. #handtx
approx 18 hrs after start
Surgeons are starting to close up the right hand #handtx
approx 19 hrs after start
Extra tissue is needed to finish closing the right hand. A skin graft is being taken from the patient's leg for this. #handtx
almost 20 hrs after start

Skin graft on right hand finished and hand is completely closed. Starting cleansing and bandaging. #handtx
(photo credit)

While we embrace the new ways to educate the public, Dr. Wes reminds us of  The Risks of Hospitals Live-Tweeting Surgeries.
For more information on hand transplant surgeon visit the teams’ website: 


Nayana Somaratna said...

I can remember the plastic surgeon who taught me saying that although a double hand transplant is technically more onerous than a single hand transplant, patients find it easier to cope with it later on, as they do not have an 'original' hand to compared the transplanted one to !

He also mentioned that he is not in favor of single hand transplants, as doing so involves taking immunosuppressive drugs for the rest of your lifetime - whether the cost and trouble involved in doing so is worth it (unless the patient starts out with no hands at all, in which case the improvement in quality of life is worth it).

I would be interested in knowing your thoughts on this subject !

rlbates said...

Nayana, I find myself agreeing with your mentor. In private practice, it is unlikely that I will ever be involved in an actual hand tranplant -- single or double. IF I was asked to advise a patient who needed a single, I would most likely encourage them to NOT do a tranplant, to get a good prosthetic and become adept at using it.

Using bilateral prosthetics is tough.

liz4cps said...

That's amazing. I remember years ago when we all "knew" that nerves couldn't be repaired, etc.