The move shows the growing willingness to do transplants to enhance a patient's life rather than to save it as donated hearts, livers and other organs have done in the past. More than 70 hands and at least 20 faces have been transplanted in adults, and doctors say it's clear these operations are safe enough to offer to children in certain cases, too.
"We feel that this is justifiable," said Dr. Amir Taghinia, who will lead the pediatric hand program at Boston Children's Hospital.
"Children will potentially benefit even more from this procedure than adults" because they regrow nerves more quickly and have more problems from prosthetic hands, he said.
Only one hand transplant is known to have been done in a child — a baby in Malaysia in 2000. Because the donor was a twin who died at birth, her sister did not need to take drugs to prevent rejection.
That's the main risk in offering children hand transplants — the immune-suppressing drugs carry side effects and may raise the risk of cancer over the long term.
However, one independent expert thinks the gains may be worth it in certain cases.
"We understand so much more about immune suppression" that it's less of a risk to put children on the drugs, said Dr. Simon Horslen, medical director of the liver and intestine transplant program at Seattle Children's Hospital. "This is never going to be done as an emergency procedure, so the families will have plenty of opportunity to weigh the options."
Also, a hand can be removed if rejection occurs, and that would not leave the child worse off than before the transplant, Horslen said.
Image: Child's hand in hospital, via Shutterstock