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Health

Having a double hand transplant means I can ruffle my son’s hair again 

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Every two weeks, Corinne Hutton has a manicure. It’s a fixed date in her diary, as Corinne takes great care to ensure that her hands and nails always look their best.

This is not from vanity, though: it is Corinne’s way of thanking the stranger who donated the hands three years ago this week.

‘I spoil myself now — I feel I have a responsibility to look after my hands so they look good all the time,’ says the 51-year-old former businesswoman from Lochwinnoch, Scotland, who now runs a charity. 

‘Every time I have a manicure, I thank my donor. I make sure I am always grateful.’

Corinne lost her hands and legs to sepsis in 2013. With sepsis, the immune system over-reacts to an infection (in her case, pneumonia), starving the limbs and organs of blood

Corinne lost her hands and legs to sepsis in 2013. With sepsis, the immune system over-reacts to an infection (in her case, pneumonia), starving the limbs and organs of blood

Since her transplant surgery three years ago, Corinne has undergone intense daily physiotherapy for up to four hours a day to help her to master the intricate hand movements that are second nature to most of us.

She had to re-learn how to twist her wrists to tilt and drink from a cup, for example — and all of this while also looking after her son Rory, 13.

She now has 95 per cent movement and sensitivity in her right hand, and 75 per cent in her left — far more than the goal she was originally given of a maximum of 75 per cent in each hand.

‘Last month, I managed to tear open a salt sachet — the first time I have managed that in years,’ she says. ‘It was brilliant.

‘The only things I struggle with today are zips and buttons on the back of dresses. I have to be able to see what I’m doing, and a button needs a lot of pushing, twisting and pulling, which most people don’t really think about.

‘Sometimes, I’ve had to ask a taxi driver to undo the top for me when I come home, otherwise I’d have to sleep in the dress,’ she jokes.

Corinne lost her hands and legs to sepsis in 2013. With sepsis, the immune system over-reacts to an infection (in her case, pneumonia), starving the limbs and organs of blood.

She became a quadruple amputee and had to learn to manage the hundreds of tasks that make up everyday life using the stumps at her wrists and prosthetic legs.

Since her transplant surgery three years ago, Corinne has undergone intense daily physiotherapy for up to four hours a day to help her to master the intricate hand movements that are second nature to most of us

Since her transplant surgery three years ago, Corinne has undergone intense daily physiotherapy for up to four hours a day to help her to master the intricate hand movements that are second nature to most of us

As a single mother to Rory, who was then only four, even the simplest of movements was hard. ‘Everything had to be clenched between my stumps,’ she recalls.

She was given a bionic left hand which picked up signals from her brain — enabling her to point a finger or clench her fist, for example.

While this improved life substantially, enabling Corinne to put on make-up and get dressed, for instance, it was cumbersome to strap on and no use for touch-screen activities.

Nor could she hold little Rory’s hand or ruffle his hair. These simple acts of parental affection were denied to mother and son.

Then, in 2014, she became the first patient in the UK to go on the waiting list for a double hand transplant, after contacting Professor Simon Kay, a consultant plastic surgeon at Leeds Teaching Hospitals NHS Trust.

Professor Kay leads the UK’s only hand transplant unit and successfully performed the first single hand transplant on Mark Cahill, a former pub landlord from West Yorkshire, in 2012.

Not only did the hand transform his own life — Mark had lost the use of his right hand as a result of gout — but in 2016 he was able to keep his wife alive, as his donated hand enabled him to perform chest compressions when she stopped breathing following a heart attack, he told his local newspaper afterwards.

But even after being accepted onto the waiting list, Corinne had to wait another five years for a match. In January 2019, she finally got the call that her life-changing double transplant could go ahead, making her the sixth patient in the UK to undergo such pioneering surgery.

‘I’d had false alarms before, so even then I was initially nervous and sceptical that it would actually go ahead,’ she says.

‘My next thoughts were ‘Who was going to look after my son Rory?’ and ‘How was I going to travel from Glasgow to the hospital in Leeds?’

Her five-year wait was in part caused by another legacy of her battle with sepsis.

In January 2019, she finally got the call that her life-changing double transplant could go ahead, making her the sixth patient in the UK to undergo such pioneering surgery

In January 2019, she finally got the call that her life-changing double transplant could go ahead, making her the sixth patient in the UK to undergo such pioneering surgery

Corinne had needed 25 blood transfusions as part of her life- saving treatment. This meant she had so many different antibodies in her system from the donated blood that finding donor hands that her body would not reject was extremely difficult.

The donated hands also had to be matched for skin texture, age and size.

Nor was it only a biological battle that Corinne had to face.

She also had to prove she had the mental strength for the surgery, and the commitment to do the necessary physiotherapy — which, as she found out, can mean years of repetitive daily exercises.

She would need to take anti-rejection drugs for life, too.

Patients are psychologically assessed four times over a year before being accepted on to the waiting list. Nine out of ten people don’t meet the criteria set by Professor Kay’s team, so never make it as far as the waiting list.

Such strict regulation of the criteria is important, says Professor Kay, as having new hands is very different from an organ transplant, which is usually a life-saving operation. Patients must be able to cope with the permanent reminder of their transplant, as the hands, unlike a donated kidney or heart, say, are on show every day.

‘Just as you live behind your face, you live in front of your hands,’ says Professor Kay, ‘as you use them all the time to communicate, to touch your face . . . in a myriad of ways.’

It is also possible that, despite taking anti-rejection drugs, the recipient’s body may reject the new hands — and patients must be deemed robust enough to cope with that.

Happily for Corinne, she met the demanding criteria. After her illness, she’d set up a charity, Finding Your Feet, to support fellow amputees, and climbed Mount Kilimanjaro on her prosthetic legs as a fundraiser. It showed she had the determination needed to get her new hands to work as normal after surgery.

Her 12-hour surgery, on January 6, 2019, involved four teams of surgeons and nurses. The complex process began with the bones being attached to each other with titanium screws, using microscopes to guide the surgery.

Since the operation, she's taken part in a variety of adrenaline-fuelled activities — including zip-lining in Snowdonia and wing-walking on a biplane — to raise more than £10,000 for her charity

Since the operation, she’s taken part in a variety of adrenaline-fuelled activities — including zip-lining in Snowdonia and wing-walking on a biplane — to raise more than £10,000 for her charity

Next, Professor Kay and his surgical team used clamps to stop the blood supply to the area. They then had just a two-hour window in which to attach the muscles, tendons, blood vessels and nerves before it was necessary to get the blood flowing once more.

After waking from surgery, Corinne’s hands were splinted and wrapped in bubble wrap — but she could glimpse her new fingers showing through. ‘I knew they were mine,’ she says. ‘They’ve never looked or felt odd to me.’

Three weeks later, Corinne was able to go home, and so began the daily routine of physiotherapy exercises to get movement and sensation in her new hands.

Such was her excitement that she initially overdid it. On one occasion, she spent three hours sorting out Rory’s toy cars, which — as the sensation was only just returning at the time — caused huge blisters on her hands and meant a trip to hospital.

‘I didn’t feel any pain so I didn’t know I was doing something wrong,’ she explains.

For the first five months, progress was hampered by various infections, which meant more trips back to hospital. But slowly, she started to make steady progress.

Corinne’s initial physiotherapy involved being encouraged to use her hands to brush and dry her hair, and to do her make-up — movements that had been so difficult with her stumps.

Soon she could feel if an object was sharp; then she could sense heat. Once, four months after surgery, she was handed a can of cola on a flight to London — and realised she could sense cold.

‘It’s just amazing what our hands can detect that helps to keep us from danger,’ she says.

For the first year, she diligently spent up to four hours a day practising her exercises. She still flexes her hands daily, opening and closing a clothes peg as she watches TV, for instance. She also has a wrist roller to help with flexibility, and uses it as often as she can every day.

There are still some oddities following the connection of nerves, which can cause a delay in recognising what she is feeling.

‘When I touch something, there is a bit of a delay and I have to stop and think what am I feeling, then it eventually registers,’ she says. ‘Or I might have a cut by the nail of my little finger but it’s my index finger that actually feels it, so I look at the wrong finger for the cause of the pain!’

However, she has been assured that, over time, the nerve signals will align completely.

And while she can pick something up from the floor and apply eyeliner, she admits: ‘I can’t hold a nail in one hand and then hammer it in with the other. But I keep pushing myself so I will get there eventually.’

Corinne says no one can see anything different about her hands when she’s wearing a long-sleeved top as the hands are so cosmetically well matched, and many comment on the strength of her grip.

It’s often only when she tells her story that people realise she has new hands.

‘At the supermarket, people were really patient with me at the checkout when they saw my stumps. But now they think my hands are normal, they’re not as tolerant when I take a while to pack the bags and pay,’ she says.

Hand transplants are slightly different from other organ donor transplants in that it is only when a suitable donor is identified that their families are approached by a senior nurse in organ donation to see if they would consent to such an operation.

Corinne never lets herself forget that without the family agreeing her hand transplant could go ahead, she would not be able to lead such a full life.

She typed a letter thanking them just two weeks after the surgery and they have since met up, but out of respect for the family’s privacy she does not share any details.

She says, however, they have told her that her fund-raising and active life since the transplant have helped with their loss.

‘They touched and held my hands, although they felt a little awkward doing so. They said they recognised them!’ she adds.

Professor Kay says asking the family is ‘a difficult, brave job’ and wishes changes could be made on the organ donor register website so people could make it known if they would be happy to donate limbs or other body parts.

He would like this kind of transplant surgery to be available to anyone who has lost their hands and arms in an accident, or to burns or septicaemia.

‘My ambition is for this to be a standard, unremarkable operation,’ he says. ‘We don’t have a register for people who have lost an upper limb, so I don’t know how many people would benefit from a hand transplant, but I really believe that what we do transforms lives,’ he says.

He is calling for a register to be set up to accurately record how many people in the UK suffer from limb loss. He believes this would confirm his belief that there has been a rise in the numbers, and also help to measure the value of transplants to those affected. 

‘Many people who have no hands slip into depression and all the isolation that goes with it — and that needn’t happen,’ he says.

‘Patients tell me that when we give them new limbs, they feel whole again. It’s not a question of how strong is their grip, it’s the ability to stroke a loved one’s face, or to hold a child’s hand, or be able to point.

‘Humans are the only animal that can point — but you need hands and fingers to do that.’

While Corinne can now not only point but also ruffle her son’s hair, she acknowledges that at 13, Rory is less willing to be seen holding his mum’s hand.

Since the operation, she’s taken part in a variety of adrenaline-fuelled activities — including zip-lining in Snowdonia and wing-walking on a biplane — to raise more than £10,000 for her charity.

In October, her charitable work was recognised when she was invited to meet the Queen at the State Opening of the Scottish Parliament at Holyrood Palace.

Her next ambition — as well as hoping to improve her cycling and skiing — is a fund-raising walk along the Inca trail in Peru, once such travel is allowed.

‘I’m on anti-rejection tablets for the rest of my life,’ she says, ‘as I am immunosuppressed.

‘People make me be cautious, even though I am triple jabbed. But I am determined to live as normal a life as possible.’

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