title: Unilateral hand transplant-results after 41 months.
abstract: We present the final results achieved by a young male hand transplant (HTx) recipient. Harvested from a woman. The limb was grafted at the wrist level 7 years postaccident. There were three HLA-A, -B, -DR mismatches and negative T- and B-cell crossmatches. The maintenance immunosuppression consisted of tacrolimus (trough level 10 ng/mL), steroids (5 mg/d), and mycophenolate mofetil (2 g/d). At the 41-months posttransplant follow-up the Semmens-Weinstein's monofilament tests gave positive results for both main hand nerves: ulnar nerve-blue, median-purple, which rated at S3- and S3+, respectively. The grip strength was 5.4 kg. HTx-specific evaluation systems showed the following results: Hand Transplant Score System (HTSS) 93.5; Chen grade I; Tamai score modified by Ipsen 86; DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire 65. Overall, the patient is able to perform with his transplanted hand practically all daily activities, even those requiring a combination of mobility, motor function, and sensation. He works full-time as a cart driver.
authors: Subdepartment of Limb Replantation, St Hedwig Hospital, Trzebnica, Poland. jerzy.jablecki@interia.pl
authors: J
authors: J
authors: Jablecki
authors: L
authors: L
authors: Kaczmarzyk
authors: A
authors: A
authors: Domanasiewicz
authors: A
authors: A
authors: Chelmoński
authors: J
authors: J
authors: Kaczmarzyk
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D018737:Hand Strength; D063987:Hand Transplantation; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009416:Nerve Regeneration; D012680:Sensitivity and Specificity; D014180:Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014955:Wrist Joint
chemical_list: D007166:Immunosuppressive Agents