First two bilateral hand transplantations in India (Part 3): Rehabilitation and immediate outcome

• Published in: Indian journal of plastic surgery Vol. 50; no. 2; pp. 161 - 167
• Main Authors: Sharma, Mohit, Iyer, Subramania, Kishore, P., Mathew, Jimmy, Vijayaraghavan, Sundeep, Sankaran, Ravi, Nair, Arun N., Janarthanan, R., Wakure, Abhijeet, Reddy, Raghuveer, Chetan Mali, S. M., Varma, Visakh, Chaudhari, Ashish, Dhake, Swapnil, Omkumar, Akshay
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01-05-2017; Medknow Publications and Media Pvt. Ltd; Thieme Medical Publishers Inc; Medknow Publications & Media Pvt Ltd; Thieme Medical Publishers, Inc
• Subjects: composite tissue allotransplantation; disability of shoulder and hand; Fingers & toes; Hand; hand transplant scoring system; Hands; Health aspects; Medical research; NMR; Nuclear magnetic resonance; Occupational therapy; Organ transplantation; Original; Original Article; Patients; Physical therapy; Plastic surgery; Rehabilitation; rehabilitation after hand transplantation; Transplants & implants; vascularised composite allotransplantation; India; hand transplant scoring system; disability of shoulder and hand; vascularised composite allotransplantation; Composite tissue allotransplantation; rehabilitation after hand transplantation
• ISSN: 0970-0358; 1998-376X
• DOI: 10.4103/ijps.IJPS_95_17

ABSTRACT
Introduction:
This report covers the strategies adopted for rehabilitation for the first and second dual hand transplants performed in India.
Materials and Methods:
The team, under a trained physiatrist, including physiotherapy and occupational therapy personnel, was involved in the management of both these patients. The management protocol was developed considering previous reports as well as our management strategies in the rehabilitation of the replanted hands. The involvement of the team with the patients started in the 1st week itself and continued on a daily basis for the entire year.
Results:
Outcome analysis was performed at 6 months and 1 year using the disability of shoulder and hand evaluation and hand transplant scoring system. Functional magnetic resonance imaging was done at the end of 1 year to assess the cortical integration of the transplanted hand.
Conclusion:
Despite more than 110 hands being transplanted worldwide, hand transplant remains an experimental procedure. It is still not considered the “standard of care” for hand amputees. Outcome analyses performed worldwide do indicate that the procedure can provide a substantial improvement in the quality of life for the hand amputee, especially the bilateral amputees.