Лучшие больницы для «Bilateral Hand Transplant» в Хайдарабад, Индия

Bilateral hand transplantation addresses traumatic or congenital bilateral upper-limb amputations at the wrist, transcarpal, or distal forearm level. Unlike solid organ transplants, CTA involves the transfer of a vascularized composite allograft (VCA) — a unit containing skin, subcutaneous tissue, fascia, muscle, tendon, nerve, bone, and cartilage — from a brain-dead, heart-beating deceased donor whose ABO blood group and HLA profile are matched to the recipient. The physiological consequence of bilateral hand loss extends far beyond motor deficit: patients experience profound disruption of proprioception, fine-touch discrimination, thermal sensing, and grip strength, resulting in a near-total dependence on caregivers for activities of daily living (ADLs). Neuropsychological sequelae — including phantom limb pain, post-traumatic stress disorder, and depression — are documented in over 60% of bilateral amputees, underscoring the urgency of functional restoration.

Eligibility Criteria

• Bilateral upper-limb amputation at or proximal to the radiocarpal (wrist) joint, with documented failure or inadequacy of prosthetic rehabilitation
• Age range: 18–60 years (pediatric cases evaluated individually; elderly patients excluded due to immunosuppression risk-benefit ratio)
• Adequate residual forearm musculature to enable motor re-innervation; ideally amputation level distal to the elbow (trans-radial or transcarpal)
• Documented stable psychiatric status: absence of active psychosis, substance use disorder, or personality disorders that would compromise medication adherence
• Strong social support network and confirmed commitment to a 12–24 month intensive hand therapy program
• +3 more

Required Pre-operative Diagnostics

PHASE 1 — DONOR Procurement AND Allograft Preparation

The procedure is initiated only upon confirmation of a brain-dead, hemodynamically stable donor with compatible HLA/ABO profile and negative cross-match. Ischemia time is the critical variable: warm ischemia must not exceed 6 hours, and cold ischemic time (with perfusion using University of Wisconsin or HTK solution) should ideally remain below 4–6 hours to maximize microvascular viability. The procurement team harvests both donor hands en bloc with the distal forearm, preserving maximum vessel, nerve, and tendon length. Simultaneous recipient stump preparation — debridement, vessel isolation, nerve identification, and osteotomy — is performed by a parallel team in an adjacent operating room to minimize total ischemia time.

PHASE 2 — Skeletal Fixation

Rigid skeletal fixation is the foundation of the reconstruction and is performed first to restore anatomical length and rotational alignment. Techniques include:

STAGE 1 — REMOTE EVALUATION & LISTING (4–8 weeks, conducted from home country)

• GAF Healthcare coordinates submission of complete medical records, imaging (MRI/CT angiography, nerve conduction studies), and psychiatric evaluation reports to the chosen transplant center
• Virtual multidisciplinary team (MDT) consultation with transplant surgeon, immunologist, hand therapist, and psychiatrist
• HLA typing blood samples can be drawn locally and shipped (dry ice, stabilized) to the receiving center's HLA laboratory
• Formal listing on the hospital's VCA waiting list upon MDT approval; waiting time is variable (months to years depending on donor availability)

STAGE 2 — DONOR ALERT & RAPID MOBILIZATION (24–72 hours)