Hand Transplantation 1964 – A Journey from Success to Rejection

In 1833, Scottish anatomist Charles Bell expressed his admiration for the human hand as follows:

"We have seen that this system of bones, muscles, and nerves is suited to every form and condition... and we must acknowledge that the human hand, as an instrument, is the culmination of perfection." 

In 1803, British physician Erasmus Darwin called the human hand "Heaven's first gift".

Unfortunately, people sometimes lose their hands in accidents, creating a need for hand transplantation. In 1964, Ecuadorian surgeon Roberto Elizalde performed a hand transplant on a sailor who had lost his hand in an explosion. However, the patient's body rejected the foreign tissue after two weeks because only rudimentary immunosuppressive drugs were available at the time. 

In 1998, Australian surgeon Earl Owen and French surgeon Jean-Michel Dubernerd performed a successful hand transplant on Clint Hallam, who had lost his hand in a saw accident. During the operation, the surgeons first joined the two bones in the donor's forearm to Hallam's bones. The tendons, arteries, nerves, and veins also had to be connected. Finally, the skin was stitched together.

After two successful years, during which Hallam learned to move his new fingers, he made the radical decision to stop taking the immunosuppressive drugs that protected his hand from rejection by his body. He felt that the donor hand did not belong to his body. The hand gradually began to deteriorate and lost all sensation. He asked the surgeons to remove it, and his request was granted in 2001. Hallam's case reinforces the need for transplant recipients to be psychologically motivated to continue taking their medications after transplantation.

In 2009, Jeff Kepner underwent the first double hand transplant in the United States. In 2010, a Polish soldier received two new hands from a female donor after losing his hands in a bomb explosion. 

Historical Figures Mentioned in This Article: Roberto Gilbert Elizalde (1917–1999), Jean-Michel Dubernerd (b. 1941) 

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