title: [Hand transplantation - fiction or reality?].
abstract: Hand transplantation has been indicated in selective patients after traumatic upper extremity amputation and only performed in a few centers around the world for the last decade. In comparison to solid organ transplantation, there is a challenge to overcome the host immunological barrier due to complex antigenicity of the different included tissues, the skin being the most susceptible to rejection. Patients require lifelong immunosuppression for non life-threatening conditions. Minimization of maintenance immunosuppression represents the key step for promoting wider applicability of hand transplantation. Current research is working towards the understanding mechanisms of composite tissue allograft (CTA) rejection. Worldwide, in 51 patients 72 hands (21 double hand transplants) and once both arms have been successfully transplanted since 1998.
authors.affiliation: Klinik für Plastische und Handchirurgie und Chirurgie der peripheren Nerven, Inselspital, Bern. esther.voegelin@insel.ch
authors.forename: Esther
authors.initials: E
authors.lastname: Vögelin
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D001186:Artificial Limbs; D000939:Epitopes / Q000276:immunology; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology; D006230:Hand Injuries / Q000601:surgery*; D063987:Hand Transplantation; D006782:Hospitals, Special; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011379:Prognosis; D013557:Switzerland; D014019:Tissue Donors; D014181:Transplantation Immunology / Q000276:immunology; D055815:Young Adult
chemical_list: D000939:Epitopes; D007166:Immunosuppressive Agents