427.8: Patient Definitions of Transplant “Success” of Upper Extremity VCA

Downey, Max; Kuramitsu, Brianna; Gacki-Smith, Jessica; Vanterpool, Karen B.; Luken, Michelle; Nordstrom, Michelle; Riggleman, Tiffany; Fichter, Shannon; Cooney, Carisa M.; Levan, Macey L; Tintle, Scott M.; Brandacher, Gerald; Jensen, Sally E.; Dumanian, Gregory A.; Gordon, Elisa J.

doi:10.1097/01.tp.0000888112.12470.75

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“…Many reported that their decisions in favor of pursuing upper extremity VCA were based on the prospect of regaining functionality and its associated independence, increasing social and physical confidence, and enabling more active parental involvement in childrearing; by contrast, those against pursuing upper extremity VCA reported concerns about their health or limb functioning becoming “worse off,” the rigorous rehabilitation process, and having adapted to life without upper limb(s) ( Gordon, 2022 ). Further, individuals maintained various definitions of “success” of upper extremity VCA ( Kinsley et al, 2021 ; Downey et al, 2022 ). Other research has examined patient’s perceptions of the risks and benefits of upper extremity VCA ( Jensen et al, 2014 ).…”

Section: Informed Consent and Potential Graft Loss (‘Exit-strategies’...mentioning

confidence: 99%

Psychosocial and bioethical challenges and developments for the future of vascularized composite allotransplantation: A scoping review and viewpoint of recent developments and clinical experiences in the field of vascularized composite allotransplantation

et al. 2022

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Vascularized Composite Allotransplantation (VCA) has evolved in recent years, encompassing hand, face, uterus, penile, and lower extremity transplantation. Accordingly, without centralized oversight by United States Organ Procurement and Transplantation Network (OPTN) or European Programs, centers have developed their own practices and procedures that likely vary, and accordingly, present different levels of rigor to the evaluation process, internationally. The importance of psychosocial factors in the selection process and treatment course has been widely recognized, and therefore, several approaches have been developed to standardize and guide care of VCA candidates and recipients. We propose to develop an international multidisciplinary platform for the exchange of expertise that includes clinical, patient, and research perspectives. Patient perspectives would derive from peer education and the assessment of patient-reported outcomes. To establish a foundation for such a platform, future research should review and combine current VCA protocols, to develop the ethical framework for a standardized psychosocial evaluation and follow-up of VCA candidates and recipients. This review presents a comprehensive overview of recent results in the field of VCA, developments in structural aspects of VCA, and provides viewpoints driven from clinical experience.

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Section: Informed Consent and Potential Graft Loss (‘Exit-strategies’...mentioning

confidence: 99%