Written By: Prerna Mittra | Updated : March 5, 2024 4:58 PM IST
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After more than 12 hours of being in surgery, the patient had an uneventful recovery in intensive care. (Representational image/Freepik)
In a complex and challenging surgery that lasted more than 12 hours, a 32-year-old man from Ujjain got a successful bilateral hand transplant done at Global Hospitals, Parel, Mumbai in February 2024. Performed by a team of doctors led by Dr Nilesh Satbhai, head of department -- plastic, hand, reconstructive microsurgery and transplantation, it went on to become a medical milestone for India. According to the Mayo Clinic, hand transplant is a treatment option for people who have had one or both hands amputated. They receive one or two donor hands (bilateral hand transplant) and a portion of the forearms from a person who has died. Hand transplants are performed in a small number of transplant centers worldwide.
The patient, Jeevesh Kushwah, who is a mechanical engineer from Madhya Pradesh's Ujjain, sustained a high-voltage shock while working in a steel fabrication factory almost three years ago, in December 2020.
Kushwah suffered from severe electric burns in both his arms and legs. He was taken to a nearby hospital and later treated in Indore. The doctors said his right leg and both hands would have to be amputated to ensure he survives. Within a few days, his right leg was amputated at above the knee level. After 1-2 weeks, both his hands were removed from below the elbow level.
While the patient's family arranged for artificial limbs for him, he could barely use his hands. At the most, he could stand and walk with the help of the artificial leg. The hands were not fully functional and he found them to be useless for most activities. Left with no choice, Kushwah became dependent on his brothers for assistance.
In June 2022, he met with Dr Satbhai for the first time.
"I examined [the patient] and discussed the feasibility of a bilateral hand transplantation with him and his family. He and his brother returned in January 2024, highly motivated and wanting to go ahead with the surgery. After detailed assessment and planning, we registered him for a hand transplant," said Dr Satbhai, adding that Kushwah was "very lucky" to receive hands from a brain-dead donor within a month after registering. The donor hands were also "perfectly suitable" for the patient's body frame in terms of size, colour, and appearance.
The doctor stated that the case was challenging. For one, the primary injury sustained by the patient resulted in severe scarring of both the amputation stumps. There were skin grafts over them and the underlying structures were scarred and contracted. The recipient preparation, therefore, became challenging. "Also, the donor's hands had to be dissected and prepared in a different manner so as to match the recipient's requirements. The coordination of the donor and the recipient teams was crucial; donor hands travelled from Surat to Mumbai, and the recipient rushed from Ujjain to Mumbai."
After more than 12 hours of being in surgery, the patient had an uneventful recovery in intensive care. He was discharged on March 2, 2024. "The patient was mobilised out of bed within 4-5 days of the surgery, and passive physiotherapy started. He is likely to gain reasonable hand function in the next 6-9 months. He will be on lifelong immunosuppression, and will have to take the required precautions and care for the same," said Dr Satbhai.
The patient said that losing hands was excruciating for him, as he felt he lost a part of himself. "Everyday tasks became daunting. The frustration and helplessness were overwhelming. I was dependent on others for simple things like holding objects, wearing clothes, eating, tying my shoelaces, brushing my hair, and even for my personal hygiene."
Now, he wishes to regain his independence and self-respect, and pursue all his dreams and goals.
