The First Hand Allotransplantation in Taiwan

Kuo, Yur‐Ren; Chen, Chien‐Chang; Chen, Yen-Chou; Yeh, Ming-Chung; Lin, Pao-Yuan; Lee, Chen‐Hsiang; Chang, Jyh-Jong; Lin, Yi-Chien; Huang, Shun‐Chen; Chiang, Yuan‐Cheng; Chiu, Nan-Tsing; Yu, Liang; Huang, Yu‐Chi; Liang, Jia; Wu, Re‐Wen; Siu, Ka-Kit; Chung, Kuan‐Chih; Chiang, Min-Hsien; Pan, Cheng‐Chung; Wei, Fu‐Chan

doi:10.1097/sap.0000000000000758

Cited by 14 publications

(11 citation statements)

References 19 publications

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“…The donor allografts are extremely difficult to obtain, and early vascular compromise should be detected whenever possible. [19][20][21][22] In addition, the blood flow velocity at the proximal point was higher than the distal point. We believe that this result reflects both the longer distance from the pedicle and also the smaller caliber of the blood vessels distally.…”

Section: Discussionmentioning

confidence: 99%

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Real-Time Assessment of Free Flap Capillary Circulation Using Videocapillaroscopy

Matsui

2022

Plastic &Amp; Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

“…The donor allografts are extremely difficult to obtain, and early vascular compromise should be detected whenever possible. 19–22…”

Section: Discussionmentioning

confidence: 99%

Real-Time Assessment of Free Flap Capillary Circulation Using Videocapillaroscopy

Matsui

2022

Plastic &Amp; Reconstructive Surgery

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“…We also found that the incidence of complications in patients with cuttinginjurywassignificantlylowerthanthatinpatientswithcrush andavulsioninjury(P<0.05).Itcanbeseenthatmusclefunctionis very important for the survival of replantation. Some researchers have even performed allogeneic hand transplantation for patients withlimbamputationandhaveachievedgoodefficacy [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of three different nerve repair strategies (repair, autografting and allografting) in one-stage replantation to treat upper extremity amputation

Lin

et al. 2021

Handchir Mikrochir Plast Chir

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Objective To examine the efficacy of three different nerve repair methods for one-stage replantation to treat complete upper extremity amputation and long-term postoperative functional recovery. Methods Twenty-five patients underwent direct nerve anastomosis (Group A), for patients with nerve defects greater than 3 cm, nerve autograft transplantation be used (Group B), or patients with nerve defects less than 3 cm, nerve allograft transplantation be used (Group C) based on the severity of injury. The Disabilities of the Arm, Shoulder, and Hand (DASH) score (higher score means poorer function-less than 25 means good effect) and visual analogue scale (VAS) scores for pain at rest and under exertion were measured. Sensation recovery time and grip function were recorded. Results The mean follow-up time was 78 ± 29 months. Group A had the lowest DASH score, while Group C had the highest DASH score. DASH score differed significantly between the three groups (P < 0.001). Sensation was not restored in two patients in Group B and two patients in Group C, and there were significant between-group differences in sensation recovery (P = 0.001). Group C had the lowest VAS score, while Group A had the highest, and there were significant differences between groups (P = 0.044). Only one patient in Group C recovered grip function. Conclusion Direct nerve anastomosis should be performed whenever possible in replantation surgery for complete upper extremity amputation, as the nerve function recovery after direct nerve anastomosis is better than that after nerve autograft transplantation or nerve allograft transplantation. Two-stage nerve autograft transplantation can be performed in patients who do not achieve functional recovery long after nerve allograft transplantation.

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“…He received a transplantation of the left distal forearm and hand from a brain‐dead male donor. The transplant procedure was described in our previous reports (Kuo et al, ). No intraoperative complications were encountered.…”

Section: Case Reportmentioning

confidence: 99%

Bone infarction of the hip after hand allotransplantation: A case report

et al. 2018

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Vascularized composite allotransplantation represents as an emerging field in reconstructive surgery. However, some complications can be associated with the procedure. The authors describe a case of bone infarctions of the bilateral hip joints following the first hand allotransplantation in Taiwan. A 45‐year‐old man who experienced a traumatic amputation of the distal third of his forearm received a hand transplantation from a brain‐dead donor. Immunosuppression included antithymocyte globulins, and bolus methylprednisolone (Solu‐Medrol) was used for the induction. The maintenance therapy protocol included systemic tacrolimus, mycophenolate mofetil, and prednisone. The patient discontinued the systemic steroid 15 months after surgery. Two episodes of acute rejections were observed at 105 and 810 days after surgery. These signs disappeared after pulse therapy with Solu‐Medrol, titration with tacrolimus, and topical immunosuppressive creams (tacrolimus and clobetasol). However, the patient felt pain in both hips after long periods of standing 30 months after the transplantation. A pelvic radiograph and magnetic resonance imaging revealed avascular necrosis (AVN) in both hip joints. Because of the progressive worsening of the pain, the patient underwent a decompression surgery on the left hip involving a fibula bone graft. The patient underwent a right hip hemi‐arthroplasty with a bipolar prosthesis 3 months later. The patient remained in good health without major complications. These findings indicate that systemic steroids and tacrolimus might be the major predisposing factors for the induction of AVN after hand allotransplantation.

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The First Hand Allotransplantation in Taiwan

Cited by 14 publications

References 19 publications

Real-Time Assessment of Free Flap Capillary Circulation Using Videocapillaroscopy

Real-Time Assessment of Free Flap Capillary Circulation Using Videocapillaroscopy

Long-term follow-up of three different nerve repair strategies (repair, autografting and allografting) in one-stage replantation to treat upper extremity amputation

Bone infarction of the hip after hand allotransplantation: A case report

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