title: Hand transplantation--a review.
abstract: Hand transplantation is a treatment option for complex injuries that leave patients with structural, functional, and aesthetic deficits that cannot be addressed by other means. It is a form of vascularized composite tissue allotransplantation (CTA). CTA is the highest rung the reconstructive ladder due to its complex technical and immunologic challenges. Despite completion of the first successful hand transplant in 1999, our understanding of hand transplantation is still evolving. Ongoing research is needed to improve functional outcomes and decrease the morbidity associated with long-term immunosuppression. This review will discuss the current protocols for upper extremity donation, transplant receipt, surgical technique, postoperative rehabilitation and immunosuppression, nerve regeneration, functional outcomes, ethical issues, and financial considerations.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: MacKay
authors.forename: Elliot
authors.initials: E
authors.lastname: Nacke
authors.forename: Martin
authors.initials: M
authors.lastname: Posner
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006225:Hand / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D006230:Hand Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D063987:Hand Transplantation / Q000009:adverse effects / Q000534:rehabilitation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009416:Nerve Regeneration; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents