As a child, Amir Taghinia, MD, was fascinated by the mechanics behind how things worked.
“I was always taking things apart and trying to fix them,” says Taghinia, surgical director of Boston Children’s Hospital’s newly launched Hand Transplant Program. “I ruined more than one toy truck back in the day, but it never upset me much. For me, the excitement of seeing how the individual parts worked together, and the challenge of trying to re-create it, was more fun than the toy anyway. ”
It’s a fascination that would stay with Taghinia from grade school to medical school, where he focused his studies on plastic surgery, taking specific interest in the hand. With more than 25 bones, 20 tendons, three major nerves and multiple veins and arteries, the human hand is one of the more intricate parts of our anatomy, making it the perfect field of study for Taghinia’s interests.
But Taghinia’s reverence for the hand is more than just an appreciation for its complex makeup and functional use—he views our hands as an extension of our personalities.
“Hands are about so much more than just functionality, they help define us,” he says, his eyes coming alive as he waves his own hands in the air for added effect. “Whether you’re expressing emotion through hand gestures, or touching a loved one, our hands are usually deeply involved in our interactions. To me, it makes them compelling in a different way than organs that have traditionally been transplanted, like livers or kidneys.”
As a plastic surgery resident years ago, Taghinia first heard about hand transplants being done in adult patients. The idea intrigued him, but at the time, there were too many variables associated with the procedure for it to be considered safe for children.
But as the surgical and medical therapies used in transplant medicine have improved, he knew it was only a matter of time until this could be offered to children. He began researching the process deeper, and has since been part of surgical teams at Brigham and Women’s Hospital and Massachusetts General Hospital, performing hand transplants on adult patients.
After assisting in adult hand transplants, Taghinia’s thoughts returned to his own patients, specifically those whose injuries were beyond current treatments. “Over the years, I worked with many children who had hand conditions that just couldn’t be helped with traditional surgery, but I still felt compelled to help them,” he says. “Children have a natural ability to quickly regain function and regrow nerves, so when transplant medicine had evolved to the point it is now I knew the time was right to provide the option to children.”
Because pediatric hand transplantation has never been done before, Boston Children’s clinicians will preform a limited number of procedures as part of a research protocol on a carefully chosen group of participants, then closely monitor how well the transplanted limbs work and grow over the years. (To learn more about the screening process click here.)
After the patient has been screened and approved for transplant, multiple medical experts will be assembled for the operations, each with a very unique role in caring for the patient. In all, eight to 12 doctors will be involved in the surgery, with each hand requiring separate surgical teams to secure the donated hands and carry out the transplant. And once the 16-hour operation has been completed, a separate team of doctors, nurses, social workers and psychologists will provide detailed follow-up care, ensuring each patient adjusts to his or her new hands as well as possible.
“The general expertise you find at Boston Children’s allows us push the boundaries of what’s possible in ways you won’t find in many other places,” he says. “Our team features renowned experts in hand surgery and rehabilitation, transplantation and immunosuppression. With this combined experience level, I’m confident that we can take great care of patients who choose to participate in this program.”
To learn more about Boston Children’s Hand Transplant Program, including its screening process for potential patients, visit its website.