title: Perceptions of the risks and benefits of upper limb transplantation among individuals with upper limb amputations.
abstract: BACKGROUND
  Upper limb transplantation is a life-enhancing rather than life-saving procedure. Little research has investigated how individuals with upper limb amputations perceive the benefits and risks of this complex procedure. To address this knowledge gap, the authors conducted qualitative research with individuals with upper limb amputations to understand their perspectives.
  
  
  METHODS
  Twenty-two individuals with upper limb amputations (age range, 24 to 73 years) participated in a focus group (n=5) or semistructured interview (n=17) about the benefits and risks of upper limb transplantation. Data were analyzed by means of constant comparative methods and a two-phase analysis process.
  
  
  RESULTS
  Participants identified enhanced functional performance and improved appearance as the greatest potential benefits. Over half of participants indicated that function was a more important consideration than appearance. Enhanced function performance was a relative concept strongly influenced by individual expectations, which varied widely. Increased sensation, psychological well-being, and social acceptability were also described as potential benefits. Identified risks included health risks and the demands of transplantation and recovery, decreased functional performance, and uncertainty over outcomes from upper limb transplantation as an experimental procedure. Participants also expressed concerns regarding the psychological impact of negative outcomes and adverse events.
  
  
  CONCLUSIONS
  Participants had a large variation in their perceived importance of the many risks and benefits of upper limb transplantation. These findings elucidate how potential upper limb transplantation candidates evaluate the benefits and risks of the procedure. The findings can also inform important issues to address and outcomes to assess in the pretransplant and posttransplant settings.
authors: Chicago, Ill. From the Department of Medical Social Sciences, the Department of Surgery, Division of Organ Transplantation, the Department of Physical Medicine and Rehabilitation, and the Department of Surgery, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine; the Rehabilitation Institute of Chicago; and the Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago.
authors: Sally E
authors: SE
authors: Jensen
authors: Zeeshan
authors: Z
authors: Butt
authors: Allen W
authors: AW
authors: Heinemann
authors: Susan
authors: S
authors: Magasi
authors: David
authors: D
authors: Cella
authors: Todd A
authors: TA
authors: Kuiken
authors: Gregory A
authors: GA
authors: Dumanian
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods* / Q000523:psychology; D001828:Body Image; D015331:Cohort Studies; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000379:methods / Q000523:psychology*; D010465:Perception; D011182:Postoperative Care / Q000379:methods; D011788:Quality of Life; D018570:Risk Assessment; D012938:Social Perception; D014481:United States; D034941:Upper Extremity / Q000601:surgery*; D055815:Young Adult