Psychiatric assessment of candidates for hand transplantation.

An important part of the pretransplant evaluation of candidates for hand transplantation is a psychiatric assessment to formulate psychological benefits and risks of transplantation and determine any appropriate psychosocial interventions to optimize the patient's candidacy for the procedure and prevent psychiatric morbidity. Screening data are presented from 213 individuals who contacted a national referral center for hand surgery regarding hand transplantation, and from the subsequent detailed psychiatric assessments of 9 individuals considering the procedure. Most of the nine patients undergoing intensive psychiatric assessment were assessed as demonstrating an overall favorable profile of psychological benefits and risks. In addition to providing information regarding the psychological experience of patients with amputations and their motivation for hand transplantation, it is hoped this information, as compared with posttransplant outcome data, will help further refine the assessment of candidates for this procedure and possibly other forms of composite tissue allotransplantation.