33-year-old Rajasthan man first in Asia to undergo total arm transplant in Mumbai hospital

A 33-year-old man from Rajasthan has become the first in Asia to successfully undergo a bilateral total arm transplant in February at Global Hospitals in Parel, Mumbai.

Twelve years ago, Ajmer resident Prema Ram accidentally touched a live electric pole while at work. He suffered multiple electric burns on both his arms and was rushed to a nearby hospital, where doctors said the arms would have to be amputated for him to survive. Ram's family had tried to get him artificial limbs, however they could not be fully functional.

His arms were amputated almost from the shoulder — at that time performing a bilateral total arm transplant was not possible in India and cost a fortune abroad.

"I was devastated after I lost both my arms. At the beginning, it was extremely challenging, I had to take the help of my family to perform daily chores. But I did not give up. I always believed there would be a solution to this," said Ram, who then went on to complete his education and also took his B.Ed exams recently.

The surgery: Recovery, functionality, cost and more

In October last year, he registered with Global Hospitals to get the total arm transplant. "The donor limb matched the patient's hand colour and size," said Dr Nilesh G. Satbhai, Head of Department, Plastic, Hand & Reconstructive Microsurgery and Transplant Surgery, Global Hospitals, Mumbai.

The surgery was performed at the hospital on February 9 and lasted 16 hours, following which the patient was monitored for four weeks. He was discharged a month later on March 9.

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The patient has to undergo regular physiotherapy for his shoulders for the next one-and-a-half to two years, following which his arms would be reasonably functional in 18 months.

Earlier, Dr Satbhai had said a bilateral total arm transplant had been done in Europe and this is a first for Asia. "Doing an arm transplant at such a proximal level is very challenging. It is a race against time. During the procedure, timing and coordination are important so that the limbs are attached to the body as early as possible so that the blood circulation begins immediately as a large number of muscles are being transferred," he said, adding that conducting a similar surgery on both sides add to the technical and logistical challenges.

Dr Vivek Talaulikar, COO, IHH Healthcare India & CEO Gleneagles Global Hospital, Mumbai, clarified that artificial arms provide very limited function to the amputees. "A transplant is the only option for them to regain useful hand function to live a normal life," he said.

However, it is important to note that while Ram will be able to use his arms in the next two years, they would still not reach the same functionality as natural arms. During the press conference on March 17, the doctors clarified the same.

While the cost for the surgery is around Rs 20-25 lakh in India, the doctors said like most medical surgeries/facilities, it is much cheaper than in the western countries.

"Arm transplants are often termed as medical miracles and can be transformative for amputees who have lost functional use of their limbs such as Ram. We strive to raise awareness of the importance of hand donation as that will encourage more individuals and families to consider this option when making decisions about organ donation," said Anurag Yadav, CEO IHH Healthcare India.

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