Twenty years ago, on January 13, 2000, a team from the Lyon University Hospital successfully performed the first double hand transplant. A look back at the surgical prowess that paved the way for similar interventions.
Remember: twenty years ago, on January 13, 2000, the first double hand transplant was performed at the Édouard-Herriot hospital in Lyon. The patient: Denis Chatelier, 33 years old. This former house painter, married and father of two children, had lost both his hands in 1996, while handling a homemade rocket.
A very heavy operation
Carried out by Professor Jean-Michel Dubernard and his team, the intervention lasted seventeen hours. It had required the mobilization of nearly fifty caregivers, including eighteen surgeons. Asked by RTL, he remembers the challenge that the operation represented at the time. “First the immunological challenge, or how to prevent rejection of the tissues that make up the graft. Secondly, the technical challenge: I assembled an international team of microsurgeons for the operation. And the psychological challenge, or how to live with someone else’s hands in front of them all the time.”
Denis Chatelier’s hand transplant has a precedent: that of Clint Halam, a 48-year-old New Zealander, who had his entire forearm transplanted on September 23, 1998. However, unlike him, Denis Chatelier did not was transplanted only a few centimeters from the wrists, which allowed him to recover better motor skills and greater sensitivity of the hands.
The operation, very heavy, has since been scrupulously followed since it requires the taking of anti-rejection treatment for life, with many side effects. “The problem of chronic rejection exists for all organs. We know that the life expectancy of a kidney is around 10 years. There is a progressive and continuous attack of the vessels which close little by little, and there is no more irrigation. But this duration is very variable according to the patients… 20 years later, Denis Chatelier is doing well for example! it is a hope”, explains to France info Professor Laurent Lantieri, plastic surgeon and reconstructor at the Georges Pompidou European Hospital.
Technical progress but a lack of funding
Twenty years later, this great first paved the way for other transplants, even more elaborate thanks, in particular, to 3D modelling. “Efforts are also being made to improve graft transport with an oxygen carrier, such as sea worm hemoglobin. This allows the organ to be preserved, so that it does not suffer from a lack of oxygen”, analyzes Professor Laurent Lantieri.
However, this type of operation is still rare in France, says Professor Dubernard, who points to the “funding problem” and the lack of teams dedicated to these transplants. “We need a very serious reorganization of the hospital system. We did a total of eight transplants, one on one hand, 7 on both hands. Of these 7, two had to be amputated, one for rejection and the second because the patient could not stand the treatment. The others are fine, but things are not organized for it to work”, concludes the surgeon.
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