title: Bilateral hand transplantation: Functional benefits assessment in five patients with a mean follow-up of 7.6 years (range 4-13 years).
abstract: Between January 2000 and July 2009, five adults who had suffered bilateral traumatic below-elbow amputations, received bilateral hand-forearm allografts performed by the Lyon team. We report the functional benefits achieved over a mean follow-up period of 7.6 years (range 4-13 years), up to December 31st, 2013. Clinical measurement is hampered by the lack of specific validated assessment tools, obliging us to use non-specific standardized evaluation means. Our assessment shows that the restoration of motion, strength, and sensibility are fair. Functional results (Carroll upper extremity function test, 400-point test, Activities of daily living) are good, as well as quality of life evaluation (RAND-36). Subjective and overall results explored with questionnaires - Disabilities of the Arm Shoulder and Hand (DASH), Hand Transplantation Score System (HTSS), are very good. Improvement was seen to continue during the first three years, and then tend to become stable. Continued efforts should be directed at designing comprehensive, condition-specific, reliable outcome measurement tools. Continuous monitoring and evaluation of patients is required to assess the long-term risk-benefit balance.
authors: Romans Ferrari Rehabilitation Centre, Miribel, France.
authors: Laurence
authors: L
authors: Bernardon
authors: Clinique du Parc, Lyon, France; Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France. Electronic address: a.gazarian@cliniqueduparclyon.com.
authors: Aram
authors: A
authors: Gazarian
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Palmina
authors: P
authors: Petruzzo
authors: McMaster University, Hamilton, Canada.
authors: Tara
authors: T
authors: Packham
authors: Romans Ferrari Rehabilitation Centre, Miribel, France.
authors: Michel
authors: M
authors: Guillot
authors: Clinique du Parc, Lyon, France.
authors: Vincent
authors: V
authors: Guigal
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Emmanuel
authors: E
authors: Morelon
authors: Xijing Hospital, Xi'an, China.
authors: Hua
authors: H
authors: Pan
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Jean-Michel
authors: JM
authors: Dubernard
authors: Clinique du Parc, Lyon, France.
authors: Christophe
authors: C
authors: Rizzo
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Patrick
authors: P
authors: Feugier
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Thibault
authors: T
authors: Streichenberger
authors: Clinique Kennedy, Montélimar, France.
authors: Ludovic
authors: L
authors: Bincaz
authors: Clinique Médipôle de Savoie, Challes-les-Eaux, France.
authors: Jean-Pierre
authors: JP
authors: Urien
authors: Clinique Kennedy, Montélimar, France.
authors: Guillaume
authors: G
authors: Mezzadri
authors: Centre de l'Hospitalisation Privée de la Loire, Saint Etienne, France.
authors: Thibault
authors: T
authors: Rousselon
authors: Hôpital Nord-Ouest, Villefranche-sur-Saône, France.
authors: Franck
authors: F
authors: Plotard
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Christian
authors: C
authors: Seulin
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Fabienne
authors: F
authors: Braye
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Ali
authors: A
authors: Mojallal
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Guillaume
authors: G
authors: Herzberg
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Jean
authors: J
authors: Kanitakis
authors: Arabkir Joint Medical Centre, Yerevan, Armenia.
authors: Davit
authors: D
authors: Abrahamyan
authors: Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
authors: Simon
authors: S
authors: Kay
authors: Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors: Lionel
authors: L
authors: Badet
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006085:Graft Survival; D006230:Hand Injuries / Q000175:diagnosis / Q000601:surgery*; D018737:Hand Strength; D063987:Hand Transplantation / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012494:Sampling Studies; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bilateral hand allotransplantation; Bilateral hand amputee; Functional outcome; Quality of life