title: Bone healing after secondary surgery on hand allografts under sirolimus-based maintenance immunosuppression.
abstract: Composite tissue allograft transplantation is a recognized option for reconstruction in upper limb amputees. Sirolimus is an immunosuppressive drug that prevents organ rejection and improves kidney function, but its use has been associated with impaired healing. Two recipients of bilateral hand allografts underwent arthrodeses of 6 joints as secondary procedures while being treated with sirolimus. We found no clinical or radiologic evidence of bone healing delay or bone nonunion. The functional evaluation revealed an improvement in the performance of activities of daily living after the transplant and secondary procedures. We conclude that bone surgery can be performed safely in recipients of hand allografts who are receiving sirolimus-based immunosuppressive therapy.
authors.affiliation: Transplant Surgery Division, University Hospital "La Fe," Valencia, Spain.
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Cavadas
authors.forename: Izaro
authors.initials: I
authors.lastname: Hernan
authors.forename: Luis
authors.initials: L
authors.lastname: Landin
authors.forename: Alessandro
authors.initials: A
authors.lastname: Thione
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery; D001134:Arm Injuries / Q000601:surgery; D001174:Arthrodesis; D001842:Bone and Bones / Q000502:physiology*; D052737:Carpometacarpal Joints / Q000601:surgery; D005260:Female; D006085:Graft Survival; D063987:Hand Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000601:surgery; D008875:Middle Aged; D020123:Sirolimus / Q000009:adverse effects / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects*; D014955:Wrist Joint / Q000601:surgery
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus