Doctors Baffled By Transplant Patient's New Hands Changing Color

Shreya Siddanagowda shortly after her groundbreaking double-hand transplant surgery at The Amrita Institute of Medical Sciences (Amrita Hospital). Amrita Hospital

Doctors in India have recently been scratching their heads after a hand transplant patient's new hands appear to have turned the same color as the rest of her skin.

Shreya Siddanagowda received a double hand transplant in 2017, aged just 19 years old at the time, at Amrita Hospital in Kerala after she was involved in a bus accident that resulted in the amputation of both her hands. She received the hands and forearms, just above the elbow, of a recently deceased male. Aside from the minor problem of the hands being a slightly darker skin tone to the rest of her body, the transplant was an outstanding success. 

Now 21, Siddanagowda's hands have reportedly turned lighter to match the rest of her skin tone, The Indian Express newspaper reports. Her doctors remain unsure how this happened since similar cases are few and far between. 

However, they’re keeping a close eye on Siddanagowda's case and hope to include it in an upcoming paper. Their current suspicion is that it’s associated with the production of melanin, the natural pigment that gives human skin and hair their color. Alternatively, it could just be the donor hand “naturally” changing color over time. 

“We are hoping to publish two cases of hand transplant in a scientific journal. It will take time. We are recording the color change in [Siddanagowda's] case, but we need more evidence to understand the change in [the] shape of the fingers and hands,” Dr Subramania Iyer, head of plastic and reconstructive surgery at Amrita Institute, told The Indian Express.

“An Afghan soldier, who received a double-hand transplant from a male donor here, had also noticed a slight change in skin tone but he died in Afghanistan last week. We could not document much.” 

Fewer than 100 hand transplants have been reported worldwide in the past 25 years and only nine cases where the transplant includes parts of the upper arm, so there’s not a huge wealth of information on the topic. This operation was also from a male-to-female donor transplant, which the surgeons say could further complicate the issue. 

The first semi-successful operation was completed in 1998 on Clint Hallam, a man in New Zealand who lost his hand in a saw accident in prison. It was eventually amputated after Hallam stopped taking immunosuppressive drugs while on the run from police for his involvement in another scam (it’s a long and strange story). 

It’s also an intensely complicated operation, even compared to other transplants. Siddanagowda's operation lasted 13 hours and required a team of 20 surgeons and a 16-member anesthetic team. For perspective, heart transplant surgery usually takes just 4 to 6 hours. 

Regardless of the recent color change, Siddanagowda has been overjoyed with the results. She’ll shortly be heading to college to study economics after successfully passing her exams (which, by the way, she wrote by hand).

“I don’t know how the transformation occurred. But it feels like my own hands now. The skin color was very dark after the transplant, not that it was ever my concern, but now it matches my tone,” added Siddanagowda.



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