Limb Transplants -- Modern Miracle or Future Frankenstein?

Limb Transplants -- Modern Miracle or Future Frankenstein?

We all know that transplants save lives. Liver, heart, renal, and other organ transplants are hardly controversial. But what happens when transplants do not save lives? What happens when they actually endanger them? At least twenty-one hands and arms have been transplanted since 1998 (and one in 1964) (1). Sure, the cosmetic and functional value of having a new hand could seem like a miracle to those without hands or arms, but do these benefits outweigh the risks?

Limb attachments are not uncommon. Dr V Pathmanathan and his team, who transplanted a left arm onto baby Chong Lih Ying from her twin sister who had died at birth, had already performed over 300 such operations (2). The controversy occurs when the limb is not simply reattached, but is transplanted from one person to another. This is because limb transplant patients, like any other transplant patients, need to be given anti-rejection medication, immunosuppressive therapy (1), so that the body's immune system does not recognize the new limb's tissue as foreign and destroy it (3). In fact, Chong Lih Ying was the only limb transplant patient not to receive immunosuppressive drugs. Because her arm was transplanted from her twin, there was very little risk of rejection (2).

As the name suggests, immunosuppressant drugs given to limb transplant patients greatly lower the body's immune system (4). This puts limb transplant patients at a much greater risk of cancer, infections, and other disorders (5), as has been the case in renal and liver transplants (6). Even with these drugs, the patient still has a great risk of rejection. Six weeks after Jerry Fisher's hand transplant, he had already experienced three episodes of rejection, a common and expected occurrence in limb transplant patients (7).

To avoid rejection, and to regain functions of the limb, limb transplant patients must follow a strict regime of intense physical therapy. During the period immediately preceding his hand transplant, Jerry Fisher underwent a two-hour physical therapy session six days a week, as well as therapy exercises on his own every two hours (7). Even so, normal functions of the limb come slowly, and according to test results to date, a transplanted limb will never have the full function of a limb with which one was born (6).

Transplant recipients must also undergo intense psychological therapy in order to view the hand as part of the self and not to associate it with the deceased body from which it came.