Toronto doc­tors per­form Canada’s first hand and fore­arm trans­plant

The Guardian (Charlottetown) - - CANADA -

A group of Toronto doc­tors have suc­cess­fully per­formed a hand and fore­arm trans­plant — the first in Canada — paving the way for the spe­cial­ized pro­ce­dure to be of­fered in the coun­try.

The lengthy op­er­a­tion, which took place in Toronto, in­volved a 49-year-old woman who had lost her arm below the el­bow in an ac­ci­dent sev­eral years ago.

“To the best of our knowl­edge, it is the first one for Canada,” said Dr. Steven McCabe, who led the surgery at the Toronto Western Hos­pi­tal. “It’s not a break­through as far as do­ing a new op­er­a­tion, but it means that we have it avail­able now here and that we have a ca­pa­bil­ity of do­ing this pro­ce­dure.”

McCabe was part of a team in Louisville, Ky., that per­formed the world’s first suc­cess­ful hand trans­plant in 1999. He re­turned to Canada three and a half years ago to be­come the di­rec­tor of Toronto Western Hos­pi­tal’s hand and up­per ex­trem­ity trans­plant pro­gram.

At that time, work to­wards car­ry­ing out Canada’s first up­per limb trans­plant was al­ready un­der­way at the Univer­sity Health Net­work, which op­er­ates four of Toronto’s ma­jor hospi­tals, in­clud­ing Toronto Western.

Af­ter a pa­tient for the trans­plant was iden­ti­fied a rig­or­ous se­ries of tests were car­ried out, McCabe said.

“We have a very thor­ough med­i­cal, psy­cho­log­i­cal and sur­gi­cal eval­u­a­tion to make sure that the pro­ce­dure can have a good hope of work­ing well. And also that the pa­tients are safe to use the im­muno-su­pres­sion med­i­ca­tion and that they have good sup­port through­out the trans­plant process,” he said. “In this pa­tient’s case, it was prob­a­bly more than a one-year process.”

Sur­geons also prac­tised in a sim­u­la­tion fa­cil­ity prior to the ac­tual pro­ce­dure, McCabe added.

The trans­plant, which was per­formed ear­lier this month, took about 14 hours and in­volved 18 sur­geons.

While the sur­gi­cal tech­niques used were sim­i­lar to what had been em­ployed in the U.S. dur­ing the first such trans­plant, McCabe said im­prove­ments in the im­munol­ogy field over time have in­creased the pro­ce­dure’s chances of suc­cess.

The trans­plant re­cip­i­ent, who is not be­ing iden­ti­fied, is re­cov­er­ing well, but still doesn’t have move­ment in her hand, McCabe said.


Doc­tors wrap a pa­tient’s arm in a splint at Toronto Western Hos­pi­tal in Toronto in this un­dated hand­out photo. Canada’s first hand trans­plant has been suc­cess­fully per­formed by a team of doc­tors in Toronto.

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