October 16 2000 at 10:11AM

Time will tell for baby given dead twin's arm

By Marty Logan

Kuala Lumpur - When Chong Lih Ying reaches a chubby, dimpled arm for the furry Garfield toy dancing in front of her, she looks like just another baby.

But it's only thanks to Malaysian surgeons that she can perform the feat at all. In a 15-hour operation five months ago, they sewed an arm on to the baby's malformed left limb - and the donor was her identical twin sister.

"I never expected in my career as a hand and micro-surgeon to receive such a call," said Dr V Pathmanathan, the lead surgeon. "It was actually a tremendous opportunity to do something that was never done before."
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'It was actually a tremendous opportunity'

Lih Ying was born without an arm. Her twin sister had severe brain damage and died at birth.

When Lih Ying was four weeks old, Pathmanathan and his team of 55 from Selayang Hospital attached the sister's limb to Lih Ying's stump - and became the first in the world to transplant an arm onto a baby.

Pathmanathan visited Singapore last week to describe the operation to the 22nd World Congress of the International College of Surgeons.

"We felt very confident that we should be able to do it," said the surgeon in an interview. His team has been together more than 10 years and performed more than 300 limb attachments.

"We spent a week researching, even practising every step of the operation."

'We spent a week researching, even practising'

The procedure was also significant, he says, because doctors didn't use immuno-suppressant drugs to help the baby adapt to the new limb. As the arm came from an identical twin, the chance of rejection was low.

In the first week after the operation, the hand swelled up.

"Initially we were struggling even to keep the hand alive. Now we are very happy that the swelling has come down, the hand is growing, the elbow is functioning, the wrist is functioning," Pathmanathan said.