Bilateral hand transplantation: Functional benefits assessment in five patients with a mean follow-up of 7.6 years (range 4–13 years)

Bernardon, Laurence; Gazarian, Aram; Petruzzo, Palmina; Packham, Tara; Guillot, Michel; Guigal, V.; Morélon, Emmanuel; Hua, Peng; Dubernard, Jean‐Michel; Rizzo, C.; Feugier, Patrick; Streichenberger, T.; Bincaz, Ludovic; Urien, Jean-Pierre; Mezzadri, G.; Rousselon, T.; Plotard, F.; Seulin, Christian; Braye, F.; Mojallal, Ali; Herzberg, Guillaume; Kanitakis, Jean; Abrahamyan, Davit; Kay, Simon; Badet, Lionel

doi:10.1016/j.bjps.2015.07.007

Cited by 43 publications

(36 citation statements)

References 52 publications

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“…[12,46] Notably, even 15 years after hand transplantation, the functional results seem to be constant, although regular therapy is important to maintain the achieved capacities. [28,29]…”

Section: Discussionmentioning

confidence: 99%

“…[26] The ARAT was performed according to the standardized approach [27] and is used by different hand transplant programs for functional evaluation. [17,28,29] The SHAP is a clinically validated hand function test and was originally developed to assess the effectiveness of upper-limb prostheses, and has also been applied for the assessment of musculoskeletal and neurological conditions. [30] It is made up of 8 abstract objects and 14 ADL with each task timed by the participants themselves.…”

Section: Methodsmentioning

confidence: 99%

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Functional and Psychosocial Outcomes of Hand Transplantation Compared with Prosthetic Fitting in Below-Elbow Amputees: A Multicenter Cohort Study

et al. 2016

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BackgroundHand-transplantation and improvements in the field of prostheses opened new frontiers in restoring hand function in below-elbow amputees. Both concepts aim at restoring reliable hand function, however, the indications, advantages and limitations for each treatment must be carefully considered depending on level and extent of amputation. Here we report our findings of a multi-center cohort study comparing hand function and quality-of-life of people with transplanted versus prosthetic hands.MethodsHand function in amputees with either transplant or prostheses was tested with Action Research Arm Test (ARAT), Southampton Hand Assessment Procedure (SHAP) and the Disabilities of the Arm, Shoulder and Hand measure (DASH). Quality-of-life was compared with the Short-Form 36 (SF-36).ResultsTransplanted patients (n = 5) achieved a mean ARAT score of 40.86 ± 8.07 and an average SHAP score of 75.00 ± 11.06. Prosthetic patients (n = 7) achieved a mean ARAT score of 39.00 ± 3.61 and an average SHAP score of 75.43 ± 10.81. There was no significant difference between transplanted and prosthetic hands in ARAT, SHAP or DASH. While quality-of-life metrics were equivocal for four scales of the SF-36, transplanted patients reported significantly higher scores in “role-physical” (p = 0.006), “vitality” (p = 0.008), “role-emotional” (p = 0.035) and “mental-health” (p = 0.003).ConclusionsThe indications for hand transplantation or prosthetic fitting in below-elbow amputees require careful consideration. As functional outcomes were not significantly different between groups, patient’s best interests and the route of least harm should guide treatment. Due to the immunosuppressive side-effects, the indication for allotransplantation must still be restrictive, the best being bilateral amputees.

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“…[12,46] Notably, even 15 years after hand transplantation, the functional results seem to be constant, although regular therapy is important to maintain the achieved capacities. [28,29]…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Functional and Psychosocial Outcomes of Hand Transplantation Compared with Prosthetic Fitting in Below-Elbow Amputees: A Multicenter Cohort Study

et al. 2016

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“…Recuperarea poate fi începută precoce şi este intensificată după reinervarea musculaturii antebraţului. Transferurile tendinoase sunt utile pentru a câştiga mai mult din funcţia musculaturii intrinseci a mâinii şi artrodezele articulaţiilor pot îmbunătăţi funcţia motorie [18,20,21].…”

Section: Transplantul De Membru Toracicunclassified

Current status of vascularized composite allografts transplant

Grosu-Bularda¹,

Lascăr²,

Teodoreanu³

2019

Ro J Med Pract.

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RezumatIntroducere. După anul 1998, când a fost efectuat primul transplant de mână în Franţa, la Lyon, s-a produs o dezvoltare neaşteptată a chirurgiei reconstructive de transplant. Transplanturile alogrefelor vascularizate compozite (VCA) se adresează unor pacienţi atent selectionaţi, în instituţii acreditate, pentru îmbunătăţirea prognosticului funcţional şi a calitaţii vieţii acestora. Scopul acestei lucrari este trecerea în revistă a rezultatelor clinice obţinute în transplantul vascularizat compozit la nivel mondial. Metodă. Au fost analizate publicaţiile relevante în domeniul alotransplantului vascularizat compozit, inclusiv datele din cadrul Registrului Internaţional de Transplant de Mână şi Ţesuturi Compozite (International Registry on Hand and Composite Tissue Transplantation:IRHCTT), resursă de mare importanţă în evaluarea globală a transplanturilor tisulare compozite. Rezultate şi discuţii. Până în prezent, au fost efectuate la nivel mondial peste 200 de astfel de proceduri, cu numeroase aplicaţii clinice, incluzând transplanturi ale membrelor toracice uni sau bilaterale, transplant de faţă, laringe, trahee, perete abdominal, membru pelvin, uter şi penis. Având o experienţă clinică de aproape două decenii, cu standardizarea indicaţiilor şi protocoalelor chirurgicale, singurele limitări în ceea ce priveşte utilizarea pe scară largă a alogrefelor vascularizate compozite sunt aspectele imunologice: fiind proceduri non-vitale, devine discutabilă expunerea pacienţilor la terapie imunosupresoare pentru tot restul vieţii, cu efectele adverse legate de administrarea acesteia. Concluzii. Chirurgia reconstructivă de transplant are potenţial să devină un standard terapeutic, fiind unica soluţie reconstructivă în cazul anumitor defecte tisulare complexe, implicând multiple structuri cu importanţă funcţională, imposibil de reparat utilizând tehnicile chirurgicale convenţionale. Rezultatele favorabile atestând fezabilitatea acestor tehnici, depăşirea dilemelor etice, elaborarea unor protocoale chirurgicale şi imunologice standardizate asigură extinderea utilizării alotransplanturilor vascularizate compozite în practica clinică. Cuvinte cheie: transplant, alogrefe vascularizate compozite (VCA), transplant de mână, transplant de faţă, imunosupresie Abstract Introduction. The field of composite tissue allotransplatation became a clinical reality since first hand transplant performed in 1998 at Lyon, France and has been progressing over the past two decades. Vascularized composite allotransplantation (VCA) is now performed for life enhancing indications in a selected group of patients under institutional protocols.Aim. This paper is an attempt to review the outcomes of VCA to date. Method. Analysis of relevant publications of composite tissue allotransplantation was performed, including the International Registry on Hand and Composite Tissue Transplantation (IRHCTT).Results and discussion. To date, there are more than 200 composite tissue allograft transplants performed worldwide, including upper limb, face, larynx, tr...

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“…Недавно была опубликована статья, в которой коллеги из Франции сообщили об отдаленных результатах нескольких билатеральных трансплантаций конечностей, в том числе произведенной впервые в мире трансплантации обеих предплечий. Это операция, за которой следует продолжительный и тяжелый курс реабилитации, включающий регулярные упражнения и физиотерапевтические процедуры на фоне постоянного пожизненного приема иммуносупрессорных препаратов [38].…”

Section: успехи в нашей странеunclassified

Replantation and Transplantation as Restoration Methods of Amputated Limbs or Its Segments

Novikov¹,

Klyuchevsky²,

Pshenisnov³

et al. 2016

Issues of Reconstructive and Plastic Surgery

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ГБОУ ВПО «Ярославский государственный медицинский университет»Минздрава России, г. Ярославль ГАУЗ ЯО КБ СМП им. Н.В. Соловьёва, г. Ярославль Потеря конечности или ее сегментов -большая утрата и может привести не только к потере трудоспо-собности, но и нарушить жизнь человека в целом. Именно поэтому восстановление потерянной части тела интересовало человечество с давних времен. Начиная с экспериментов макрореплантации и трансплантации конечностей, медицина постепенно дошла до уровня аллотрансплантации конечностей в клинической прак-тике, а возможности современной микрохирургии позволили реплантировать отчлененные кончики пальцев или устранить дефекты дистальных фаланг пальцев кисти путем пересадки со стопы. В статье приведен крат-кий исторический очерк развития вопроса реплантации и трансплантации конечностей на примере клиниче-ского и экспериментального опыта ярославской школы.Ключевые слова: отчленение, реплантация, трансплантация, аллотрансплантация, конечность.Amputation of the limb or its segments is a big loss for a human and can lead not only to loss of ability to work, but also disrupt a person's life. That is why the restoration of lost body parts interested mankind since historic times. Since experiments on macroreplantation and limb transplants, medicine gradually reached the level of limb allograft in clinical practice, and the possibilities of modern microsurgery allow the replantation of amputated fingertips or elimination of the distal phalangeal defects by transplanting from the foot. The article gives a brief historical sketch of the development of limb replantation and transplantation on the example of clinical and experimental experience of the Yaroslavl School.

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Bilateral hand transplantation: Functional benefits assessment in five patients with a mean follow-up of 7.6 years (range 4–13 years)

Cited by 43 publications

References 52 publications

Functional and Psychosocial Outcomes of Hand Transplantation Compared with Prosthetic Fitting in Below-Elbow Amputees: A Multicenter Cohort Study

Functional and Psychosocial Outcomes of Hand Transplantation Compared with Prosthetic Fitting in Below-Elbow Amputees: A Multicenter Cohort Study

Current status of vascularized composite allografts transplant

Replantation and Transplantation as Restoration Methods of Amputated Limbs or Its Segments

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