The loss of an arm or hand is a disabling, life-changing injury. The ability to perform simple daily activities is frequently lost and the amputee often requires full-time assistance. Luckily for many, surgical advances are building hope, with transplants often able to restore both functionality and independence.

“A hand amputation is a devastating injury, not just because of the loss of function, but because the human hand is used in everyday social interactions and in expression of human emotions,” said W. P. Andrew Lee, M.D., Executive Vice President for Academic Affairs, Provost, and Dean of UT Southwestern Medical School, and an internationally recognized hand and transplant surgeon.

“Even with all the advances in prosthetics, these devices do not fully replace the multiple tasks of the human hand, including the ability to touch and to feel. Therefore, the best replacement for an amputated human hand, in both form and function, is transplantation of another human hand from a deceased donor,” Dr. Lee said.

While only about 130 arm and hand transplants have been performed worldwide since 1998, Dr. Lee has helped pioneer such procedures while leading a multidisciplinary team at Johns Hopkins Medicine and at the University of Pittsburgh. Those procedures included a bilateral arm and hand transplant in 2012 on a wounded U.S. Marine who lost both arms and legs to an improvised explosive device (IED) in Iraq in 2009. With the transplant, the man regained full independence, including driving and hunting.

Dr. Lee, who led the first double-hand transplant (2009) and the first above-the-elbow arm transplant (2010) in the United States, will talk about his experience as a hand transplant pioneer, “New Frontiers in Transplantation: Hand and Arm Transplants,” as part of the President’s Lecture Series at 4 p.m. Thursday, Oct. 27, in the Tom and Lula Gooch Auditorium and online. A reception will follow.

While hand and arm transplants help restore functionality, Dr. Lee said they are not without risks. Heavy doses of immunosuppressant medications given to prevent rejection of the limb can have serious side effects such as organ toxicity and opportunistic infections, he said.

But advances in transplantation and anti-rejection medicines have made hand transplantation an increasingly feasible option, Dr. Lee said. “Our team set out to shift the risk-benefit balance in favor of hand transplantation through immune modulation such that its benefits in enhancing the quality of life are not outweighed by the toxicity of high-dose systemic immunosuppressants,” he said. From his laboratory research on limb transplants, he found that injecting donor bone marrow cells intravenously into the recipient was effective in reducing the number of anti-rejection medications necessary to prevent rejection from three to one (monotherapy), thus significantly limiting their side effects.

Dr. Lee credits the success of arm and hand transplants to the multidisciplinary transplant team, made up of specialists in orthopedics, plastic surgery, transplant surgery, infectious diseases, nephrology, psychiatry, physical medicine and rehabilitation, as well as hand therapists, nurses, and social workers, among others. Each person and each specialty contribute its own expertise to the process. A collaborative team is also a prescription for success in areas of life beyond medicine, he said.

“When it comes to pushing forward the clinical frontier, building an academic department, pursuing a career path, or enhancing a professional association, the spirit of inclusion and team building is not only advantageous but also a powerful formula for success,” as he noted in his presidential address “Power of Inclusion” to the American Society for Surgery of the Hand in 2012.

Dr. Lee, an international leader in hand transplantation, joined UT Southwestern in 2019. Before that, he was Director (Chair) of the Department of Plastic and Reconstructive Surgery at Johns Hopkins School of Medicine. Besides the arm transplants, he led surgical teams that performed the world’s first total penis and scrotum transplant in 2018. He also was on the faculty at Massachusetts General Hospital, Harvard Medical School, and the University of Pittsburgh School of Medicine.

Dr. Lee received his undergraduate degree from Harvard College and completed medical school and a general surgery residency at Johns Hopkins, followed by plastic surgery training at Massachusetts General Hospital.