Requirements for the development of a hand transplantation program.
Since 1998, 42 hand transplants in 30 patients have been performed in countries such as France, United States, China, Austria, Malaysia, Italy, Belgium, Poland, Spain, and Germany. Now, with recent improvements in immunosuppression, the clinical applicability may expand and the ethical obstacles may soon be overcome, allowing multiple US institutions to perform hand allotransplantation. The main purpose of this article is to facilitate access to pertinent details in regards to hand transplantation, such as donor/recipient selection criteria, immunosuppressive therapies, and associated complications. It is a comprehensive literature review compiled from published reports from multiple hand transplant programs throughout the world. Due to its inherent complexity, hand transplantation should only be attempted at institutions within the US capable of orchestrating a specialized multidisciplinary team, and each institution's protocol should be extremely detailed and individualized.
Gordon
Chad R
CR
Department of Plastic Surgery, The Cleveland Clinic, Cleveland, OH 44195, USA. gordonc@ccf.org
Siemionow
Maria
M
D003131:Combined Modality Therapy; D046148:Donor Selection; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006230:Hand Injuries / Q000601:surgery*; D063987:Hand Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007400:Interprofessional Relations; D008297:Male; D016377:Organ Transplantation / Q000592:standards / Q000639:trends; D010348:Patient Care Team; D018579:Patient Selection; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D016730:Program Development; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D014481:United States
D007166:Immunosuppressive Agents