Health Check: What Price Would You Pay for a Limb Transplant?

Article excerpt

RIVALRY IN medicine is no different from that in any other field of human endeavour.

Who remembers the second person to climb Everest or walk on the moon - and who will bother to record the second transplant of a human hand? The race to be first involves risk but it is the driving force that brings scientific advance, social progress and, er, research grants.

Except that medical advances involve two people - and it is the patient, not the doctor, who takes the risk. Many men died trying to climb Everest but they were a danger only to themselves. The team that last week claimed the world's first transplant using a donor hand put their patient, Clint Hallam, a New Zealander, at risk.

The operation was clearly undertaken with his consent, and there is no reason to suppose that the risks were not fully explained to him. Mr Hallam, who lost his right hand in an accident with a chain saw nine years ago, was so keen to acquire a replacement that he had booked a consultation with a team in Kentucky in the US on the very day that he went under the knife in Paris. "We rang his wife in Australia who said: `He isn't going to meet you - he's got a new hand now'," said a miffed US researcher.

It is clear, too, that the international team that undertook the transplant was aware of the risk.

Professor Nadey Hakim, the British transplant expert from St Mary's hospital, London, said after the operation: "You have to dare in medicine or it does not advance." But was the risk justified? Some experts have their doubts. The risk derives not from the complexity of the surgery, which, while not routine, is certainly beyond the experimental stage - dozens of patients have had their own hands reattached after accidents, with varying degrees of success - but from the immune reaction that could be triggered by the foreign limb. …