New Delhi: Blending technical intricacies with surgical precision, doctors at Sir Ganga Ram Hospital have successfully performed a rare bilateral hand transplant on a 34-year-old mother of two, offering her a renewed chance at independence nearly two years after she lost both her limbs in a farm accident.
The resident of a village in Haryana had both her hands amputated in July 2024 after they were caught in a chaff-cutting machine during an epileptic seizure. Her life took a dramatic turn when the family of a 55-year-old brain-dead man from Delhi consented to donate his organs. The bereaved family not only donated the man's hands but also his liver, benefiting multiple recipients.
The complex surgery on the woman, conducted on April 21, lasted more than 10 hours and marked the hospital's second successful bilateral hand transplant. Teams worked simultaneously on both limbs — one at the distal forearm level and the other above the elbow or supracondylar level — making the procedure even more challenging.
Dr Anubhav Gupta, part of the plastic surgery team led by Dr Mahesh Mangal, said, "Bilateral hand transplantation is not just a surgery; it is a carefully orchestrated sequence where even a few minutes can determine graft survival. Our goal was not only to restore form, but to give the patient dignity and function." Both the hands were attached simultaneously by two teams, racing against time to restore blood circulation within the critical window of four to six hours, Dr Gupta said.
The donor limbs were preserved in a special "University of Wisconsin solution" to maintain tissue viability. Surgeons first stabilised the bones, followed by veins and arteries, before meticulously repairing the tendons and muscles. "Once structural stability is achieved, we first connect the arteries and veins to restore blood flow, ensuring the limb does not die, and then move to the muscles," Dr Gupta said. He also described the importance of flushing out old blood to reduce damage from free radicals before establishing fresh circulation.
Dr Bheem Nanda and Dr Nikhil Jhunjhunwala were also part of the plastic surgery team. Dr Jaya Sood, Dr Rakesh Saxena and Dr Ajay Sirohi formed the anaesthesia team. Other specialists included Dr Brajesh Nandan from orthopaedics, Dr Vinant Bhargava (nephrology), Dr C S Aggarwal (neurology), Dr Soumya Tandon from psychiatry, Dr Monika Jain (genetics) and Dr Pallav Gupta (pathology). Dr Varun Prakash and Dr Suchita Katoch coordinated the process.
Dr Nanda highlighted the technical challenges, noting that "maintaining tissue viability throughout the prolonged ischaemia time and ensuring stable fixation before vascular reperfusion are critical steps that demand extreme precision." Dr Jhunjhunwala emphasised that recovery does not end in the operating room. "Immunosuppression, rehabilitation and close monitoring will shape her long-term recovery and quality of life," he said.
The left hand, attached at the forearm level, is expected to regain function sooner, while the right, connected above the elbow, will require more time and rehabilitation. The patient has been shifted out of ICU and will remain under observation for a week. The doctors noted that compatibility between the donor and recipient, such as blood group and tissue matching, was carefully ensured. However, gender does not play any role in such surgeries, they said. While the donor had chronic kidney disease and other complications, his organs were viable. This case builds on the hospital's earlier success in 2024, when a female donor enabled a similar transplant for a male patient.
