The potential of composite transplant is immense and can trigger a medical revolution, says Warren Breidenbach, surgeon who led the world’s first hand transplant.
Even replacement of damaged heads is a possibility. However, the idea is at a nascent stage, said Dr. Breidenbach, a pioneer in composite tissue allotransplant, chief of Reconstructive and Plastic Surgery at the University of Arizona.
“Skin is the most allogeneic tissue in the body and most likely to reject foreign bodies.
“A revolution 16 years ago, hand transplant was done amidst a lot of applause but with some pertinent queries bordering on medical ethics,” he said.
“A lot of people were upset because they questioned the use of drugs to make the transplant possible,” said Dr. Breidenbach.
Interaction
He was in Kochi to interact with the first hand transplant recipient in India and the team behind it at the Amrita Institute of Medical Sciences.
While immunosuppressants are part and parcel of any vital organ transplant, hand transplant does not involve a life-threatening situation, he said. “People had called for cancelling my medical licence too,” he added.
“Precisely because these transplants are not done in life-saving situations, the number of hand transplants worldwide has been only about 150 so far.
“Here, the recipient has to be healthy and should willingly come up for the transplant,” Dr. Breidenbach said.
“Any organ transplant is a difficult issue from counselling to the last stitch of surgery.
Families do find it traumatic to donate hands or legs of their dear ones who had died. America too went through an educational campaign on this. It has to be a voluntary act, a gift,” he said.
How long people with transplants live had always been a tricky poser for transplant surgeons. “It is still too early to say but the person who had the first hand transplant is the longest surviving patient,” Dr. Breidenbach said.
Safer drugs
He said new safer drugs would have a bearing on composite transplants.
“Composite transplant was a challenge till the mid-nineties.
“But when a new technique called microsurgery and new drugs came to support research on rats and pigs, we knew that we were nearer to achieve something that was only in theory till then,” he said.
