When a suitable donor is identified and the consent for hand donation is received, the suitable listed recipients are informed and called at the earliest.

A cross-match test is then performed to check the compatibility between the donor and the recipient. If the crossmatch is favourable, then the transplant is performed. The donor’s hand is retrieved. Simultaneously the recipient amputation stumps are prepared. The donor’s hands are dissected and prepared. All the structures are sequentially attached and repaired. The bones are fixed, and blood vessels, muscles, tendons, nerves and skin are repaired.

This is a prolonged surgery which takes 12-16 hours, depending on the level of injury and the extent of damage to the amputated stump.