TIL that the first man to get a hand transplant begged doctors to amputate it after several months because he had become “mentally detached” from it.

TIL that the first man to get a hand transplant begged doctors to amputate it after several months because he had become “mentally detached” from it.
TIL that the first man to get a hand transplant begged doctors to amputate it after several month...

Mentally detached probably because he didn't take the required anti rejection medicine and it cause the hand to shrivel and become grotesque.

That and the patient is a serial fraudster and compulsive liar. Really interesting case. On a side note, cadaveric transplantation is where the future of prosthetics lie tbh.

wait wait wait. so if I lose my legs and get given some cadaver legs, would that make me a dead man walking?

To be fair, the care and maintenance for this is pretty complex. It's easy to say that this guy is a scumbag loser who badly mishandled his transplant plus lied a lot and committed fraud. But doing everything necessary isn't easy, and it may fail, anyway. I believe this hand transplant was significant in another way: it may have been the first time that a transplant was done for a non-lifesaving reason. Transplants are dangerous enough that medical ethicists rejected doing it for anything but vital organs. But as better anti-rejection drugs have been developed, with lower health risks, doctors have started doing transplants for non-vital organs--hands and faces, most notably, but also penis and uterus (though uterus transplants are intended to be temporary, just long enough to complete childbearing). There's an article on Cracked.com by Jane Halston, who had a hand transplant. This sounds like a very committed and dedicated person -- she lost both legs and parts of both hands to disease, and was very committed to having a new hand. She'd already been through hell, and survived. She had to do 6 hours of physical therapy/day for almost 3 years. The anti-rejection drugs she was taking caused kidney failure and she had all kinds of other complications that you can read about if you search for the article. The guy who had the first hand transplant may not have been able to articulate all of the problems he had, and he wasn't a star patient, but still, diabetes is pretty bad. Did he also have kidney problems or rejection problems? The article is too vague to tell. We know he stopped taking the meds because he wanted the hand to rot so they'd have to take it off. But before that happened, were things so bad that it really should have been taken off, from an impartial perspective?

You are right. The article makes it seem like it's his fault completely. Not only did he stop taking the anti-rejection drugs, but he lied about how he lost his hand in the first place.

And with him being the first hand transplant ever, imagine how much he set the field back for everyone else

I kinda disagree. Lower limb prosthethics can return close to full functionality these days (see pistorious and the guys who just ran a bunch of marathons as a double amputee.)

I think the future lies in robotic prosthethics with brain(nerve)-computer interfaces

Ideally, also role models who aren't murderers.

So it's definitely a pros vs. cons type scenario, but if we're really thinking long term and in global sense I do think limb transplants are better. I'll try to outline some of my thoughts on why prosthetics are likely not to be the long-term standard solution. I'm just an undergrad who happens to know about this field, so take everything I say with a grain of salt - I'm actually a CS major. If anyone with more knowledge about this (especially mechanics or limb surgeries) wants to respond, I would highly appreciate it. Also, this is not related to human augmentation or the surpassing of human ability - I'm only responding in the context of rehabilitation.

The prohibitive cost of lower limb prosthetic, neural interfacing technology, and why amputation solutions need to be cost-effective.

Prosthetics are getting cooler. A lot of them are looking and performing like something out of Marvel Comics. And while this is amazing, the cost is also increasing as the technology becomes more complex. Top of the line prosthetics can be very cost-prohibitive in wealthy countries and straight-up infeasible in developing countries. They can be expensive to maintain and trouble-shoot.

Who is paying for this technology? Is there a market for these super high end prosthetics? If not, will we keep developing them?

The highest end prosthetics will never reach the average amputee, not due to lack of professionals or engineers, but likely due to socioeconomic factors. The sexy solutions we are creating are not going to work in the developing world.

Growing up with your prosthetic

This is pretty straightforward. All the cute videos of children with prosthetics are inspiring and amazing, but those prosthetics will have to be repeatedly altered. Probably not completely replaced as often assuming well-designed sockets, but definitely altered. Limb transplants don't have this problem, they will develop with the patient. See: Zion Harvey

The bidirectionality issue

Prosthetics are not bidirectional. You can interface to a prosthetic, but it will not communicate back. There are janky solutions, like vibrational feedback, but they are sub-optimal, non-specific, and generally inconvenient. Bioengineering solutions are in their infancy, but I do not believe they will work well in the periphery. This doesn't just mean that you can't 'feel things', it means that you don't even know where your prosthetic is. There are promising surgical architectures that have solved the latter problem, but the former remains unsolved and likely impossible.

Under special conditions, hand transplants can restore near complete sensory feedback. When I was first shown this, my mind was blown (and it made my research feel borderline pointless).

Biomechanical impossibilities

There are certain conformations that are quite simply biomechanically impossible with current prosthetics. For example, knee amputees cannot cross their legs while sitting is simple not possible. I don't work on the mechanical side, I work on the neurobiology, but I know there's several conformations like this that are huge brainfucks for the Mech. E's working on it.

It's exhausting to use a prosthetic

Like physically exhausting. People will often sit down, take breaks, and remove their prosthesis. Constantly interfacing with a neural prosthesis is mentally and physically exhausting - imagine constantly contracting one of your leg muscles all the time. Sometimes, not all the time, that's what it feels like to wear one.

I could point out the annoyance that is calculating every step and change of elevation, but in the long term this will likely be solved with AI. In some ways, it already has been with ankle prosthetics that do stair-climbing and real time adjustments for you.

Moving on...

I can usually come up with more, but it's late and I'm tired - you can probably see the quality of my writing deteriorating over time. Now I'll point out the huge, arguably larger issues with cadaveric transplants. I know I said they're the future, but before moving forward we need to understand the huge obstacles ahead.

Cost is still an issue

Surgeries are expensive and there's a limited number of surgeons. I do believe that the long term cost of a cadaveric transplant is less than the production and maintenance of a high end prosthetic. Obviously, this only applies when you're talking about the super fancy type shit - there are hundreds of prosthetics that are improvised and work moderately well, sans the neural interfacing.

Threat detected: immune system set to kill

Obviously there's a whole bunch of immune engineering that goes into play here. But hear me out, in an ideal future we would have a database of people's immune data and everyone would be opted into a limb and organ transplant system. The rate at which amputations happen relative to the rate at which people die make it very possible to quickly find someone who matches an amputees immunology (I have a colleague who actually calculated with a fair amount of rigor as a thought exercise). For reasons beyond cadaveric limb transplant, I genuinely believe it is of utmost importance to the future of medicine to construct such a database.

What was my point again?

My point isn't that limb transplants are better than prosthetics now as a general solution, nor that that they will be in the near future. But rather that when we think about the "Futorology" best case of amputee medicine we really should be looking in the direction of limb transplants. I feel like it's something not that many people know about, not even people who work on prosthetics.

The hurdles for cadaveric limb transplants are giant, but I actually think the hurdles for truly biomimetic prosthetics that interface with the brain with near-natural bidirectionality are larger.

TL;DR: it is likely better for amputees that limb transplantations are perfected rather than neural interfacing prosthetics.

yep, kelly monaco boobs

That's a hell of a "stranger". I'd probably have issue with using another man's hand to fap as well.

Fuck amputation, just give him a happy pill.

They shouldn't have taken the hand from an executed serial killer.