Requirements for the Development of a Hand Transplantation Program

Abstract

Since 1998, 42 hand transplants in 30 patients have been performed in countries such as France, United States, China, Austria, Malaysia, Italy, Belgium, Poland, Spain, and Germany. Now, with recent improvements in immunosuppression, the clinical applicability may expand and the ethical obstacles may soon be overcome, allowing multiple US institutions to perform hand allotransplantation. The main purpose of this article is to facilitate access to pertinent details in regards to hand transplantation, such as donor/recipient selection criteria, immunosuppressive therapies, and associated complications. It is a comprehensive literature review compiled from published reports from multiple hand transplant programs throughout the world. Due to its inherent complexity, hand transplantation should only be attempted at institutions within the US capable of orchestrating a specialized multidisciplinary team, and each institution's protocol should be extremely detailed and individualized.

Cost Analysis of Conventional Face Reconstruction versus Face Transplantation for Large Tissue Defects

“…Although there are not currently enough data to know what these medications cost each year, there are published comparisons in kidney and hand transplant patients that range from $6000 to $20,000 per year depending on the drug regimen. 22,28 In addition, facial allograft transplantation is unique in that no cases of graft failure and loss have yet been reported, and it is unclear what effects they would have on patient outcomes. 19 Finally, acquiring a new face is unlike acquiring a graft of any other kind; a "successful" outcome must incorporate not only morbidity and mortality data, but also aesthetic, functional, and qualityof-life metrics.…”

Social Networking Among Upper Extremity Patients

“…As many of us know, the promising subspecialty of composite tissue allotransplantation, mainly hand and face transplantation, will soon became a clinical standard. 2,3 In 2008, I started my fellowship training in plastic surgery at the Cleveland Clinic (Cleveland, OH). As time went by, I began participating, under the leadership of Dr. Maria Siemionow, as project coordinator for the face transplant project.…”

Concomitant Face and Hand Transplantation

“…Furthermore, despite the literature for both isolated hand and face transplantation, the published indications and/or contraindications are anecdotal and untested. 35,36 For example, hand amputation remains most commonly accepted indication for upper extremity transplantation.…”