January 6, 2023
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Patient Mark Cahill and surgeon Simon Kay
On December 27, 2012, the first hand transplant was performed in the UK. A decade later, we speak to the patient and the surgeon who pioneered the procedure.
“Many patients say that after surgery, small things are more important to them,” said Simon Kay OBE professor and plastic surgeon. “Brush a daughter’s hair, take money out of your pocket, or turn on the faucet to fill a glass of water…”
Or, in the case of Mark Cahill, saving his wife’s life after she suffered a heart attack.
Cahill’s surgery was performed at Leeds University Hospital, which is home to the UK’s hand transplant unit. It is the only place that performs this type of complex procedure in the country.
The site is recognized as one of the global pioneers in hand transplantation around the world, an area of medicine that seemed impossible decades ago.
Some of the patients who have walked the corridors of this hospital over the past ten years have lost hands or limbs in accidents. Others due to conditions such as sepsis or scleroderma (hardening of the skin and internal organs that damage small blood vessels).
Cahill’s case
Mark Cahill is a model patient on this medical unit. After years of suffering from gout (an inflammatory disease that mainly affects the joints), his right hand became so infected in 2012 that it had to be amputated.
It was then that his life intersected with that of “Prof,” as he calls professor and surgeon Simon Kay, a term that reflects the closeness that has developed between the two over the years.
“My mother had seen Professor Kay on TV saying he was doing hand transplants,” Cahill recalls.
“I was advised and he told me I was the ideal candidate. I talked to my family and I decided, ‘It has to be better than what I have’. And indeed it was.”
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The Cahill transplant was considered a success in Britain
Thand transplant in Great Britain
- Few families agree to donate the hands of their loved ones
- Hand donation is not an option that can be selected during organ donation registration
- Finding a compatible organ is more complex than finding other organs because physical appearance and psychological acceptance play a key role in transplant success.
- A patient assessment for one year is essential and includes psychological and immunological questions
- Recovery and the possibility of new transplants can take one to three years.
- Hand transplantation is not yet available for children, but this is an area the medical team hopes to develop.
Source: Leeds Teaching Hospitals NHS Trust
Cahill was only operated on after intensive psychological discussions. “They test your psychological state to see if you’re fit,” he said.
The day after Christmas, the call he and his family had been waiting for finally came.
“They said: Can you come? See you after the surgery.”
For him, the decision to undergo the transplant was inevitable.
The surgical team contacted the surgeons in France who performed the first hand transplant in 1998.
“They put me to sleep and I woke up with a new hand,” says Cahill, who had the transplant the next day.
“I remember waking up in the ICU and the professor came in and said, ‘Let’s look at this.'”
“I could move my fingers a little and the teacher said, ‘Don’t do it yet.’ So I thought, ‘Now it works.’ It’s amazing that it happened so quickly.”
It was months of physical therapy. “It was tough at first,” he recalls. “Your nerves take a long time to grow, and without them your movements and sensations aren’t there.”
He says the surgery changed his life because it restored what he believes to be his independence. “I used to have to ask people to do things for me. When driving a car, for example, I can drive with my right hand, which makes it much easier.”
It also saved a life when his wife Sylvia suffered a heart attack in 2016. “She was unconscious for 19 minutes and I kept her alive for at least 10 of those minutes with cardiac compressions with my right hand.”
He says he will always be grateful to the team that followed him. “They were absolutely fantastic.”
Credit, Leeds Teaching Hospitals NHS Trust
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Professor Kay and a team of specialists perform the UK’s first twohanded transplant in July 2016
Professor Kay looks back with pride. “Ten years ago we ran what was considered groundbreaking and made this service accessible, well coordinated and with one of the two most important entities in the world,” he said.
“The level of experience and quality of care provided by this team is exceptional and of course our surgeries would not have been possible without the courage and generosity of the donors and their families,” he said. “Your contributions have changed lives. Working in this field is a privilege.”
However, a decade after the first operation, hand donation is still not an eligible option in the UK donor registry.
“We need donors,” Cahill said. “It’s a very difficult question for nurses to ask people (authorized family members).”