Hand transplantation: the state-of-the-art.
The feasibility of hand transplantation has been demonstrated, both surgically and immunologically. Levels of immunosuppression comparable to regimens used in solid organ transplantation are proving sufficient to prevent graft loss. Many patients have achieved discriminative sensibility and recovery of intrinsic muscle function. In addition to restoration of function, hand transplantation offers considerable psychological benefits. The recipient's pre-operative psychological status, his motivation and his compliance with the intense rehabilitation programme are key issues. While the induction of graft specific tolerance represents a hope for the future, immunosuppression currently remains necessary and carries significant risks. Hand transplantation should, therefore, only be considered a therapeutic option for a carefully selected group of patients.
Schuind
F
F
Service d'Orthopédie-Traumatologie, Cliniques Universitaires de Bruxelles, Hôpital Erasme, 808 route de Lennik, B-1070, Brussels, Belgium. Fschuind@ulb.ac.be
Abramowicz
D
D
Schneeberger
S
S
D005240:Feasibility Studies; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006225:Hand / Q000294:innervation; D063987:Hand Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008866:Microsurgery; D009416:Nerve Regeneration / Q000502:physiology; D011183:Postoperative Complications / Q000503:physiopathology / Q000534:rehabilitation; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D018570:Risk Assessment
D007166:Immunosuppressive Agents