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Canada’s first upper limb transplant performed at UHN

​​​​Image of surgeons planning to suture the skin
Getting to the last few steps of the procedure, surgeons (including Dr. Steven McCabe, second from the left) attach the muscles and plan how to suture the skin. (Photo: UHN)​

Dr. Steven McCabe was part of the surgical team that performed the world's first hand transplant in 1999 in Louisville, Kentucky.

Fast forward 17 years and Dr. McCabe has made the possibility of hand transplants in Canada a reality, leading a multi-disciplinary team of experts to complete the country's first transplant of the upper limb.

The team at Toronto Western Hospital (TWH) successfully attached the hand and forearm from a donor to a patient who had lost her arm below the elbow in an accident several years ago.

"We are very proud to have successfully performed this forearm and hand transplant procedure," said Dr. McCabe, Director of TWH's Hand and Upper Extremity Transplant Program.

"This is a tremendous accomplishment involving many people across several programs, and we are excited to make this treatment possible and available for patients who would benefit from it."

The procedure lasted approximately 14 hours and involved 18 surgeons of a variety of different surgical disciplines from a number of hospitals.

Image of surgeons turn to preparing the donor arm to attach to the patient
With the patient ready, surgeons turn to preparing the donor arm to attach to the patient. Surgeons need to make sure that blood flow is restored to the donor limb in less than four hours. (Photo: UHN)​

To protect the privacy and confidentiality of the patient, the donor and their families, the hospital will not be releasing the date of the surgery or any possible identifying details.

"It's another milestone for our program," says Dr. Atul Humar, Director of UHN's Multi-Organ Transplant Program. "With this Canadian first, we are entering another era in transplantation.

"This kind of effort requires not only the expertise of a diverse surgical, medical, and rehabilitation team at UHN, but also a life-changing gift by a tissue and organ donor and his or her family."

UHN has Canada's largest organ transplant program, performing more than 500 transplants every year, and providing world-class follow-up care to over 5,000 recipients.

A wide range of experts are required to successfully complete the pre-transplant, transplant and post-transplant phases. This procedure was made possible by the knowledge of immune suppression and the prevention of rejection in UHN's MOT Program, Toronto Western Hospital's Hand and Upper Extremity Transplant Program, the Arthritis Program and the Trillium Gift of Life Network (TGLN) that oversees the organ donation process.

Since Dr. McCabe was part of the pioneering surgery in 1999, more than 110 hand transplants have taken place in more than a dozen countries.

Image of patient’s arteries are sutured to the donor limb’s arteries
Once the patient’s arteries are sutured to the donor limb’s arteries, blood starts to circulate in the donor limb and the hand starts to take colour as seen here. (Photo: UHN) ​

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