BACKGROUND: Limb allotransplantation is emerging as a promising solution to the loss of a limb with the development of advanced surgical techniques and new, highly effective immunosuppressive agents. METHODS: We retrospectively reviewed the records of 15 hand allotransplantations in 12 patients in China which were performed from September 1999 to May 2008. RESULTS: In total, there were 1 bilateral and 5 unilateral hand transplantations, 3 unilateral and 2 bilateral forearm transplantations, and 1 palm and 1 thumb transplantation. The average age of recipients was 34 ± 11.3 years (range, 19-52 years). At 1-year follow-up, all grafts were viable and with good function. Of the 15 hands transplanted, 8 are currently viable (mean follow-up, 52 ± 36.3 months; range, 16-112 months), including all 3 bilateral cases. Reasons for graft failure were rejection and failure of compliance with immunosuppressive therapy. CONCLUSIONS: Long-term survival of hand transplantation with appropriate immunosuppression is feasible, and satisfactory functional results have been achieved. Careful pretransplant psychologic and social evaluation, consideration of the financial burden of long-term immunosuppressive medications, and close multispecialty collaboration is critical for good outcomes. Limb rejection was related with immunosuppression use. Further study and experience is required before hand allotransplantation can become a generally recommended treatment.
BACKGROUND: Limb allotransplantation is emerging as a promising solution to the loss of a limb with the development of advanced surgical techniques and new, highly effective immunosuppressive agents. METHODS: We retrospectively reviewed the records of 15 hand allotransplantations in 12 patients in China which were performed from September 1999 to May 2008. RESULTS: In total, there were 1 bilateral and 5 unilateral hand transplantations, 3 unilateral and 2 bilateral forearm transplantations, and 1 palm and 1 thumb transplantation. The average age of recipients was 34 ± 11.3 years (range, 19-52 years). At 1-year follow-up, all grafts were viable and with good function. Of the 15 hands transplanted, 8 are currently viable (mean follow-up, 52 ± 36.3 months; range, 16-112 months), including all 3 bilateral cases. Reasons for graft failure were rejection and failure of compliance with immunosuppressive therapy. CONCLUSIONS: Long-term survival of hand transplantation with appropriate immunosuppression is feasible, and satisfactory functional results have been achieved. Careful pretransplant psychologic and social evaluation, consideration of the financial burden of long-term immunosuppressive medications, and close multispecialty collaboration is critical for good outcomes. Limb rejection was related with immunosuppression use. Further study and experience is required before hand allotransplantation can become a generally recommended treatment.
Authors: L Cendales; R Bray; H Gebel; L Brewster; R Elbein; D Farthing; M Song; D Parker; A Stillman; T Pearson; A D Kirk Journal: Am J Transplant Date: 2015-03-13 Impact factor: 8.086
Authors: Kaj Brouwers; Max F Thijssen; Anne Sophie Kruit; Dominique van Midden; Erik J Koers; Her J H Zegers; Stefan Hummelink; Dietmar J O Ulrich Journal: Plast Reconstr Surg Glob Open Date: 2022-02-21
Authors: John Heineman; Ericka M Bueno; Harriet Kiwanuka; Matthew J Carty; Christian E Sampson; Julian J Pribaz; Bohdan Pomahac; Simon G Talbot Journal: SAGE Open Med Date: 2020-05-27
Authors: Theresa Hautz; Franka Messner; Annemarie Weissenbacher; Hubert Hackl; Martin Kumnig; Marina Ninkovic; Valeria Berchtold; Johanna Krapf; Bettina G Zelger; Bernhard Zelger; Dolores Wolfram; Gerhard Pierer; Wolfgang N Löscher; Robert Zimmermann; Markus Gabl; Rohit Arora; Gerald Brandacher; Raimund Margreiter; Dietmar Öfner; Stefan Schneeberger Journal: Transpl Int Date: 2020-11-10 Impact factor: 3.842