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Options Cosmetic Prostheses Body-Powered Prostheses Electric Prostheses Myoelectric Prostheses Switch and Pressure Sensors LUKE Arm Osseointegration No Prosthesis
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Home > Hand/Arm Transplant > Functional Outcomes

Functional Outcomes

 
 

Dr. Jaimie Shores, Hand/Arm Transplant Surgeon, talks about what function can be expected from a hand/arm transplant.

 
 
 

Hand Functions

Hand/arm transplant recipients will regain many of their hand functions after hand/arm transplantation. For example, recipients can regain the ability to hold, grasp, sense touch, feel temperature, and do daily activities such as eating, driving, dressing, shaving, and writing.1,2

 
Manu and Abdul Rahim, India’s first double hand/arm transplant recipients, demonstrate holding and cutting a piece of paper with their new hands, a little over 1 year after their transplant surgeries.(Amrita Hospital)

Manu T.R. and Abdul Rahim, India’s first double hand/arm transplant recipients, demonstrate holding and cutting a piece of paper with their new hands, a little over 1 year after their transplant surgeries.
(Amrita Hospital)

Manu and Abdul Rahim shake hands over 1 year after their hand/arm transplant surgeries at Amrita Hospital in India. (Amrita Hospital)

Manu T.R. and Abdul Rahim shake hands over 1 year after their hand/arm transplant surgeries at Amrita Hospital in India.
(Amrita Hospital)

Abdul Rahim, bilateral hand transplant recipient, arm wrestles with his son.(Amrita Hospital)

Abdul Rahim, bilateral hand transplant recipient, arm wrestles with his son.
(Amrita Hospital)

 

Remember: Everyone is different. There is no guarantee that hand functions will return after surgery.

 
 
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"It’s all about practicing moving them. I’m still waiting on the nerves to grow so that I can really feel them. That will take patience and time. But the other day I felt the coldness of a can of juice, which was so incredible. I have to use my eyes all the time so that I don’t burn or hurt my hands. I can do my signature. It’s a bit hit-and-miss but it’s actually starting to look like mine. I’ve even started to eat meals holding a knife and fork in each hand, which is amazing."
- Corinne Hutton, 49-year-old female who received bilateral hand transplants in 2019

 
 
 
 

Dr. Dumanian, Chief of Plastic Surgery, talks about sensation from a hand/arm transplant compared to a prosthetic.

 

Nerve and muscle function are not restored immediately after transplantation and generally return over time. The time it takes to regain function differs for each person and depends on the type of injury and whether the amputation is above or below the elbow. In general, the return of sensory or motor function depends on nerve regeneration, which occurs at a rate of about one inch per month. It can take several months to regrow the nerves if the transplant occurred at the wrist level, or can take two or more years if the transplant occurred above the elbow or close to the shoulder. One research study showed that it can take as early as 4 months for nerves to recover after the transplant. It can take on average 9 to 15 months for hand muscles to recover after the transplant.³ 

The type of function regained, and process of regaining function are different for each person. Some recipients regain function in some areas of their hand or in fingers, but not in others.² Regaining good function after hand/arm transplantation is related to a recipient’s active participation in hand therapy and can take some recipients many years.³ Learn more about the rehabilitation process following hand/arm transplantation.

 
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"I drive. I live on my own. I have a dog. House, to take care of. Cleaning. Dishes. Cooking."
- Lindsay Ess, 32-year-old female who received bilateral hand transplants in 2011

 
 
Manu received a unilateral, below elbow hand transplant from Amrita Hospital in India. Several months after his transplant surgery, Manu was able to write a thank you note to the hand donor’s family. (Amrita Hospital)

Manu T.R. received bilateral, below elbow hand transplants from Amrita Hospital in India. Several months after his transplant surgery, Manu was able to write a thank you note to the hand donor’s family.
(Amrita Hospital)

 
 
 
 
 
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“As those nerves grow back, sometimes they can give unusual sensations to people, sensations like electric shocks and sensations like burning.”
- Dr. Simon Talbot, hand/arm transplant surgeon 

 

It is possible for hand or upper limb transplant recipients to regain hand function for: 

Temperature thermometer icon

Sensibility

This means that someone can feel hot or cold, feel pain, or sense touch and texture.3,4

Finger pinching icon

Movement

This includes motion of the forearm, wrist, thumb, and fingers. In addition, movement refers to the ability to grip and to pinch.3

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Daily activities

This covers everyday tasks that involve the hands/arms, including: bathing, dressing, eating, toileting, as well as writing, driving, cooking, and cleaning.3,5

 
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“I’d finally got my license back after months of having to depend on family and friends to take me everywhere.”
- Corinne Hutton, 49-year-old female who received bilateral hand transplants in 2019

 
 
 
 
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“I could see a little bit of the finger sticking out from the cast [after the transplant surgery], and I remember I could sort of wiggle them, very slightly, and I was just blown away by that.”
- Debra Kelly, 61-year-old female who received bilateral hand transplants in 2018

 
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“Before I could brush my teeth and it was difficult… Now I can brush my teeth and it’s easy.”
- Lindsay Ess, 32-year-old female who received bilateral hand transplants in 2011

 
 

Mr. Pollock, a bilateral, upper limb transplant recipient (11 ½ years after transplantation), demonstrates and explains how his hands function.

 
 

Click Below for More Videos

Videos of Health Care Professionals

Dr. Jaimie Shores, Hand/Arm Transplant Surgeon, describes how nerves grow in the hand/arm for a transplant recipient.

Angie Duckworth, Transplant Social Worker, talks about how hand/arm transplantation can help some people with limb loss regain hand function.

Dr. Jaimie Shores, Hand/Arm Transplant Surgeon, talks about the goals of independence and improved quality of life for hand/arm transplant recipients.

Dr. Jaimie Shores, Hand/Arm Transplant Surgeon, compares prosthetics and hand/arm transplants.

 

References

Sources

  1. Salminger S, Roche A, Sturma A, et al. Hand Transplantation versus Hand Prosthetics: pros and cons. Current Surgery Reports. 2016;4(2):8.

  2. Shores JT, Brandacher G, Lee WPA. Hand and Upper Extremity Transplantation: An Update of Outcomes in the Worldwide Experience. Plast Reconstr Surg 2015;135(2):351e-360e.

  3. Ninkovic M, Weissenbacher A, Gabl M, et al. Functional Outcome after Hand and Forearm Transplantation: What Can Be Achieved? Hand Clinics 2011;27(4):455-465.

  4. Breidenbach WC, Gonzales NR, Kaufman CL, et al. Outcomes of the First 2 American Hand Transplants at 8 and 6 Years Posttransplant. The Journal of Hand Surgery. 2008;33(7):1039-1047.

  5. Singh M, Sisk G, Carty M, et al. Functional Outcomes after Bilateral Hand Transplantation: A 3.5-Year Comprehensive Follow-up. Plast Reconstr Surg 2016;137(1):185-189.