title: Technology and vascularized composite allotransplantation (VCA)-lessons learned from the first bilateral pediatric hand transplant.
abstract: The reconstructive principle of replacing "like with like" is best met with vascularized composite allotransplantation in which the components of an existing defect are "matched" to the greatest extent possible in a single stage restoration. Hand transplantation is a labor-intensive and time-intensive process and can be conceptualized into distinct phases that include (1) patient selection and preoperative preparation, (2) technical execution of the procedure, and (3) postoperative rehabilitation and follow-up. The advent of technological innovations, such as 3D printing technology, novel implant technology, as well as innovative imaging technology, such as functional magnetic resonance imaging have the potential of favorably affecting all phases of this process, thus contributing to improved outcomes. The use of these technologies in the world's first case of bilateral hand transplantation in a pediatric patient is discussed.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University, 770 Welch Road, Suite 400, Palo Alto, CA, USA. amomeni@stanford.edu.|Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA. amomeni@stanford.edu.
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.affiliation: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chang
authors.affiliation: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA.|Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
mesh_terms: D002648:Child; D063987:Hand Transplantation / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D018579:Patient Selection; D066330:Printing, Three-Dimensional; D019651:Plastic Surgery Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome; D063986:Vascularized Composite Allotransplantation / Q000379:methods*