India Gets its First Ever National Registry for Hand Transplants

According to NOTTO officials, the creation of the registry will ensure that donated hands are allocated to recipients systematically and fairly.

In a landmark move, India has established its first-ever national registry for patients requiring hand transplants. This initiative aims to streamline and prioritize the allocation of donated hands transparently.

The registry, overseen by the National Organ and Tissue Transplant Organisation (NOTTO) under the Union Health Ministry, will centralize data on patients waiting for hand transplants nationwide.

According to NOTTO officials, the creation of the registry will ensure that donated hands are allocated to recipients systematically and fairly.

In a letter to all states and union territories, NOTTO Director Anil Kumar informed hospitals and hand transplant centers about the new registry, instructing them to register eligible patients under the "bone" category of the tissue section in the national database.

Dr Kumar explained that, until now, the registration of patients for hand transplants had not been included under the ‘Subject Demography Management’ in the national registry on the NOTTO website.

The recent directive ensures that hospitals and transplant centers across India comply with the new registration process, promoting consistency in organ allocation.

Rising Demand for Hand Transplants

Hand transplants in India have become increasingly common, with nine hospitals currently authorized to perform the procedure.

According to data collected by NOTTO, a total of 36 patients have received hand transplants to date, with 67 hands being transplanted in total.

Dr Subramania Iyer, professor and chairman of plastic and reconstructive surgery and head and neck surgery at Amrita Hospitals in Kochi, is a pioneer in hand transplants in India.

He led the country's first successful bilateral hand transplant in 2015. Dr Iyer hailed the new registry as a critical step toward boosting hand donations and ensuring their effective utilization.

Challenges in Hand Donation

Dr Iyer noted that hands can be donated after both cardiac and brain death, but the timing of the donation is critical.

While most organ donations occur after brain death, hands donated after cardiac death must be procured within 30 minutes of the heart-stopping, making it a logistically challenging process that requires a hospital-controlled environment.

Despite the challenges, awareness surrounding hand transplants has been increasing, leading to a rise in donations.

Dr Iyer emphasized that the establishment of the national registry would facilitate the proper allocation of donated hands, further encouraging both donors and recipients.

Enhancing the National Allocation Process

Talking about the allocation process, Dr Kumar from NOTTO believes that the new registry will significantly improve the national allocation process and streamline data management for hand transplants.

By centralizing information, the registry will help hospitals across the country collaborate more effectively, ensuring that patients receive transplants in a timely and efficient manner.

Dr Iyer highlighted the importance of hand transplants, especially for patients who have lost both hands due to accidents or medical conditions.

Since the 1st hand transplant in 2015, the procedure has been recognized for its utility in rehabilitating patients with amputations at various levels, including the forearm, upper arm, and shoulder.

Overcoming Barriers to Hand Transplants

While hand transplants have shown great promise in improving the lives of patients, there are still several barriers to their widespread use.

Dr Iyer also pointed out that one of the primary challenges is the lack of available hands for donation. Unlike organ donations, hand donations are often perceived as externally mutilating, which deters many potential donors.

The establishment of the national registry aims to address these concerns by creating a more organized system for hand donations and transplants.

Dr Iyer believes that this step will lead to an increase in donations, as well as better utilization of available hands, ultimately benefiting more patients in need.