India’s first hand transplant was carried out successfully at the Amrita Institute of Medical Sciences, Kochi, on 13th January 2015. More than 100 successful hand transplants have been done for several years (the first hand transplant was done in France). They have been considered to be more cost effective and efficient compared to prosthetic hands, especially in bilateral amputees. So far, hand transplants and other composite tissue allotransplant including the face have been done only in USA, European countries, Chinaand Australia. This is the first hand transplant in a coloured skin population in the world and the first in India.

The hand transplant programme was conceived in Amrita Institute of Medical Sciences three years back. The transplant team was led by Dr. Subramania Iyer, Professor and Chairman of Plastic Surgery. Two patients with bilateral amputations just above the wrist were listed in the Kerala Network for Organ Sharing. Since difficulty was anticipated in getting hands tobe donated as it would cause change in the external appearance of the donor, an extensive public awareness campaign was initiated.

One of the waiting recipients was a 30-yearold male who had lost both his hands in a tragic train accident three years back. On 12^th January 2015, a 24-year-old male patient was declared brain dead after a bike accident. His family agreed for organ donation including his hands. His blood group matched that of the waiting recipient. The procedure started at 4 AM on Tuesday, 13th January and lasted 16 hours. The hands were retrieved from the brain-dead donor and simultaneously in the adjacent operation theatre the recipient was anesthetized and both his hands were prepared. The donor was fitted with artificial limbs after the retrieval and the body was handed over to the relatives.

The recipient progressed well after the operation. As a part of rehabilitation, movements to the hand – active and passive, day-to-day activities were started under supervision. He was able to move his hands since his own forearm muscles were working to move the fingers. The sensations would start to return in three to four months.