[Psychology during the process of human hand allograft].
OBJECTIVE
To study the psychology and its management during the process of hand allograft.


METHODS
One psychologist participated through the whole process of the present hand allograft. 12 potential candidates of hand transplant were interviewed during the selection of patients to evaluate the state of psychiatry and their abilities to manage stressors like cooperation with medical workers and medical interventions, waiting for donors, adaptation to a new hand and post operation depression. The psychological state of 11 patients were believed to be able to receive hand transplant, and they are further prepared psychologically by the psychologist while waiting for a donor. Two lucky candidates were decided by tissue typing and received hand allograft simultaneously. After the operation, the two patients psychotherapy assisted with effective analgesia, supporting from family and environmental improvement.


RESULTS
One out of 12 patients was found not suitable for the transplantation because of psychiatric problem. One week postoperation, the 2 patients were anxious, lack of patience, and horrified at seeing the long-expected grafted hand. After 1 week of treatments and adapation the patients managed to settle with the new hand, and accepted the hand as a whole 1 month postoperation. With the recovery of the hand sensation and motion 4 to 5 months postoperation, the patients held the hand as his own.


CONCLUSIONS
Psychologists are required in the hand transplantation team during the pre-transplant selection of patients and post-transplant rehabilitation.
Zhu
L J
LJ
Department of Orthopedics & Traumatology, Nanfang Hospital, First Military Medical University, Guangzhou Guangdong, P. R. China 510515.
Pei
G X
GX
Gu
L Q
LQ
D000223:Adaptation, Psychological; D006230:Hand Injuries / Q000523:psychology / Q000601:surgery*; D063987:Hand Transplantation; D006801:Humans; D016377:Organ Transplantation / Q000523:psychology* / Q000534:rehabilitation; D018579:Patient Selection; D011613:Psychotherapy