Patients accepted into a new transplant program at the University of Michigan Health System will receive hands from recently deceased donors.

Amputees who have lost their hands may now have the chance to write, use a telephone and grasp objects again, thanks to a new transplant program at the University of Michigan Health System.

The procedure, referred to as a “vascular composite allograft transplantation,” involves reattaching multiple types of tissue such as fat, skin, muscle and nerve cells. Patients accepted into the program will receive hands from recently deceased donors.

The surgery is intense. It requires a team of 10 to 30 doctors depending on the complexity of each individual case, and it lasts eight to 12 hours — compared to an average of four hours for a heart transplant.

John Magee, transplant surgeon and director of the Transplant Center, said UMHS is well-positioned to offer the surgery.

“The University of Michigan re-attaches more limbs per week than most people would think,” Magee said. “The hand effort builds upon a great deal of strength we already have, and the other efforts will build upon the successes we see with hand transplants.”

The University already received approval to expand the program in the future, meaning it could soon be performing other VCA surgeries such as face transplants. According to Magee, however, those won’t come until after the program is comfortable with hand transplants.

“A central issue, of course, is making sure we are successful and that we go about this in a responsible and measured process,” he said.

Kagan Ozer, orthopaedic surgeon and the program’s surgical director, stressed that the skill of the doctors involved is only one of the important variables dictating the success of the surgery.

Finding patients with the right mindsets is also crucial.

“They have to be well-disciplined, persistent people who must be happy to carry someone else’s hand or face for the rest of their lives,” Ozer said. “That requires a certain level of commitment and ability to cope with that stress. The very first hand transplant performed in France resulted in the patient electing to get the hand removed nine months later. The patient couldn’t get over the feeling that the hand wasn’t his.”

While Ozer said the surgery team is ready to perform the procedure, the physical, functional and psychiatric screening procedures mean that the first surgery could be months away.

The VCA donation process is also different than the process for organ transplantations. Those who join the Michigan Donor Organ Registry are not considered to have given consent for their hands or faces to be used in a transplantation.

“The Michigan donor registry does not cover VCA or the hand transplant,” said Tim Makinen, spokesman for Gift of Life Michigan, the organization responsible for organ and tissue recovery in Michigan. “That is a separate authorization that Gift of Life would get from the family.”

The first hand transplantation took place in 1999, and fewer than 100 of the surgeries have been completed since.

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