Helping Hand

Though surgeons are transplanting internal organs with increasing frequency, techniques for transplanting limbs from one person to another have rarely been explored. Last week such an operation was performed, with initial success, under unlikely circumstances.

A sailor named Julio Luna Vera, 32, was brought into Ecuador's Clinica Guayaquil with a right hand so shattered by a grenade explosion that amputation was necessary. Dr. Roberto Gilbert Elizalde, 47, who had never done any transplant work, decided to try. He put a tourniquet on Luna's arm and cooled it with cracked ice. He had a donor: a 43-year-old laborer--also named Luna--who lay dying of internal hemorrhage in another Guayaquil hospital where his family gave permission for the transplant.

Ten minutes after death, Donor Luna's right forearm was removed, flushed with a clot-preventing solution, packed in ice and rushed to the clinic. There a team of surgeons worked all night with Gilbert; after ten hours Sailor Luna had a new hand.

As soon as the operation was finished, Mayo-trained Dr. Gilbert phoned Dr. Richard Wilson of Boston's Peter Bent Brigham Hospital, a pioneer transplant center.* With Wilson's help, a supply of Imuran, an anti-rejection drug, was flown to Guayaquil. Luna was given a dose of X rays to further halt the process by which the human body normally rejects foreign organisms, whatever their origin.

A week after the operation, Wilson and his Boston colleague, Dr. Robert Goldwyn, flew down to look at Luna. They found that Gilbert had done his work well. "The hand is beautifully positioned," said Goldwyn. The blood flow was good, and while the skin appeared blistered there was no sign of the feared rejection process. Says Wilson: "What the whole fate of the hand will be, I don't think either of us can say at the moment. But Dr. Gilbert has made an excellent start."

*Also in Boston: Massachusetts General Hospital, where young Everett Knowles Jr.'s own severed right arm was restored 21 months ago. Everett, now 14, has regained limited use of the arm, can hold objects, throw a ball, open doors, and has near-normal feeling in all fingers.

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