Mumbai / Man's hands I got in transplant were dark, now they match my skin tone: Pune woman

Mumbai: “Sometimes good things fall apart so that better things can fall together,” was the first sentence Shreya Siddanagowder wrote in her notebook a year after her hand transplant.

Today, her handwriting almost matches her original, but what has left doctors surprised is how the colour of Shreya’s hands, which once belonged to a 20-year-old man from Kerala until his death in August 2017, had changed to match the rest of her skin tone.

“I don’t know how the transformation occurred. But it feels like my own hands now. The skin colour was very dark after the transplant, not that it was ever my concern, but now it matches my tone,” says 21-year-old Shreya, who underwent Asia’s first inter-gender hand transplant.

Back in Kochi, where she underwent the double-hand transplant at Amrita Institute of Medical Sciences (AIMS), surgeons are researching whether female hormones could hold the key to such changes.

Globally, less than 200 hand transplants have been conducted, and no scientific evidence exists to record changes in skin tone or shape of the hand. Doctors say this is the first such case, perhaps.

“We are hoping to publish two cases of hand transplant in a scientific journal. It will take time. We are recording the colour change in (Shreya’s) case, but we need more evidence to understand the change in shape of the fingers and hands. An Afghan soldier, who received a double-hand transplant from a male donor here, had also noticed a slight change in skin tone but he died in Afghanistan last week. We could not document much,” says Dr Subramania Iyer, head of plastic and reconstructive surgery at Amrita Institute.

Plastic surgeon Dr Mohit Sharma, who was part of the team that conducted the transplant for Shreya, says there is limited research in inter-gender hand transplants.

“There was one female-to-male hand transplant in the West. But there has been no scientific research into what happens after that. In a year or so, the lymphatic channel between the donor’s hand and the host’s body opens up completely to allow flow of fluids. It is possible the Melanin-producing cells slowly replaced the donor’s cells. And that led to the change,” he says.

Melanin is a pigment that is responsible for skin colour. The more Melanin, the darker the skin colour, and doctors believe Shreya’s body produces less Melanin.

In September 2016, while travelling from her hometown in Pune to Manipal Institute of Technology in Karnataka, Shreya met with a bus accident that forced the amputation of both hands. A year later, she visited the Amrita Institute to register for the transplant.