title: The international registry on hand and composite tissue transplantation.
abstract: BACKGROUND
  Since May 2002, all groups performing hand transplantations have supplied information to the International Registry on Hand and Composite Tissue Transplantation (IRHCCT). The analysis of all cases with follow-up information up to September 2007 is presented here.
  
  
  METHODS
  From September 1998 to September 2007, 38 hands (18 unilateral and 10 bilateral hand transplantations) and two digits have been reported to IRHCTT, for a total of 30 patients with a follow-up period ranging from 6 months to 9 years. They were 28 males and two females, median age of 34 years. Time since hand loss ranged from 2 months to 34 years and in 50% of cases the level of amputation was at wrist level. Immunosuppressive therapy included tacrolimus, mycophenolate mofetil, rapamycin, and steroids; polyclonal or monoclonal antibodies were used for induction. Topical immunosuppression was also employed in several cases.
  
  
  RESULTS
  Patient survival was 100%. Graft survival was 100% at 1 and 2 years. Except for the Chinese patients, current graft survival is 95.6% and cause of graft loss was always no compliance to the treatment. Acute rejection episodes occurred in 85% of the patients within the first year and they were reversible in all compliant patients. Side-effects included opportunistic infections and metabolic complications. All patients developed protective sensibility, 90% of them developed tactile sensibility, and 72% also a discriminative sensibility. Motor recovery enabled patients to perform most daily activities.
  
  
  CONCLUSIONS
  Hand transplantation is feasible with a high success rate and satisfactory functional outcome.
authors: Department of Transplantation, Hopital Edouard Herriot, Lyon, France. petruzzo@medicina.unica.it
authors: Palmina
authors: P
authors: Petruzzo
authors: Marco
authors: M
authors: Lanzetta
authors: Jean Michel
authors: JM
authors: Dubernard
authors: Raimund
authors: R
authors: Margreiter
authors: Frédéric
authors: F
authors: Schuind
authors: Warren
authors: W
authors: Breidenbach
authors: Roberta
authors: R
authors: Nolli
authors: Stephan
authors: S
authors: Schneeberger
authors: Carlo
authors: C
authors: van Holder
authors: Christina
authors: C
authors: Kaufman
authors: Jerzy
authors: J
authors: Jablecki
authors: Luis
authors: L
authors: Landin
authors: Pedro
authors: P
authors: Cavadas
mesh_terms: D005260:Female; D007839:Functional Laterality; D063987:Hand Transplantation; D006801:Humans; D008297:Male; D012042:Registries; D016378:Tissue Transplantation / Q000706:statistics & numerical data*; D014180:Transplantation / Q000706:statistics & numerical data*