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Hand transplantation

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Unconventional decisions made by the Australian transplant team provided the best overall outcome for their patient

Hand transplantation represents the spearhead of the new field of composite tissue allotransplantation. Since the beginning of time, it has been a medical goal to replace missing tissue with like tissue. The psychological and medical importance of achieving this goal is highlighted by the story of Cosmas and Damian, two 3rd century physician saints who successfully transplanted a leg around the year 1150, long after their deaths.1

Such reports notwithstanding, the ability to transplant composite tissue remained elusive for most of the history of mankind. The modern era of hand transplantation started in 1964, when Roberto Gilbert Elizalde of Ecuador transplanted a hand onto a patient using azathioprine for immunosuppression. The hand survived for 3 weeks.2

The next attempt to transplant a hand was carried out in France on a New Zealander residing in Australia, Clint Hallam, by a team led by Jean-Michel Dubernard in September 1998.3 Earl Owen from Australia participated in the surgery. The transplanted…