Health ministry starts registration of hand transplantation patients

New Delhi: India has set up a registry for the first time for patients requiring hand transplantation, with officials saying it will facilitate the allocation of the donated organ in a transparent manner and on a priority basis.

The registration will be accepted in the national registry maintained by the National Organ and Tissue Transplant Organization (NOTTO), which falls under the agies of the Union Health Ministry. "Establishment of a registry and pan-India allocation of hands on a priority basis will give boost to the donation as well as the proper utilisation of the donated hands," said Dr Subramania Iyer, Professor and Chairman, Plastic and Reconstructive Surgery and Head and Neck Surgery, Amrita Hospitals and School of Medicine, Kochi.

Dr Iyer led the team that conducted India's first hand transplant in 2015.

NOTTO Director Anil Kumar recently wrote to the states and Union Territories informing them about the registry and told them to disseminate the information to all hand transplant centres and hospitals for compliance.

According to the letter, the registration for hand (composite tissue) transplant option is not available in "Subject Demography Management" in the national registry on the NOTTO web portal.

"Therefore, it has now been decided by the competent authority, that all the hand transplant centres/hospitals should register such patients/recipients requiring hands for transplants under the category 'bone' of the tissue section in subject demography management," the letter said.

Hand transplantation has been increasing and more and more centres are performing hand transplants, Dr Kumar said.

Presently nine hospitals are registered for performing hand transplants in the country. So far 36 patients have received hand transplants and 67 hands have been transplanted, according to the data compiled by NOTTO.

Dr Iyer said that usually organs are donated after brain death but hands can be donated both after brain death and cardiac death.

In case of a cardiac death, hands should have to be donated within half an hour after the heart has stopped and this should take place in a controlled environment within a hospital, Dr Iyer said.

Hands fall under the category of 'composite tissue', and now with increasing awareness more and more patients are seeking hand transplants and more number of donations are happening so the registration process is being initiated, Iyer said.

"This will further help NOTTO in smoothening the national allocation process and data management for hand transplant of donors and recipients," Dr Kumar said.

He stated that now with awareness, the number of hospitals performing hand transplant in the country is also increasing.

Hand transplants started in India in 2015 when a 29-year-old man underwent bilateral hand transplants, said Dr Iyer.

Since then the utility of the procedure in rehabilitating patients with hand amputation especially when both hands are lost was appreciated and several centers took it up, Dr Iyer explained.

"Hands at various levels of amputation ie. Forearm, upper arm and even at shoulder level has been carried out successfully," he said.

Apart from the technical and organisational challenges, the main factor deterring its extensive utilisation is the lack of availability of hands being donated as well as the transfer of the donated organs across the country, Dr Iyer said.

"Hand donation process being an externally mutiliating one is not perceived favourably by many when organ donation is considered. Hence the establishment of a registry and pan Indian allocation of the hands on a priority basis will give boost to the donation as well as the proper utilisation of the donated hands," Dr Iyer added.