The psychological assessment of candidates for reconstructive hand transplantation

Abstract

'Transplant psychology' -General psychological considerationsThe human hand represents a powerful physical instrument, with a variety of psychosocial functions and roles. From a psychosocial perspective, the human hand assists in interpersonal communication through touch and gestures. Humans communicate, greet each other, demonstrate intimacy and love, form and break bonds, protect and attack [1]. Reconstructive hand transplantation (RHT) represents an enormous medical advance involving parts of human anatomy that play such an important role in making us human [2].Reconstructive hand transplantation has been one of the most striking medical success stories although it differs from other forms of transplantation in numerous

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

“…[9,44,45] In general, patients with bilateral amputation suffer especially from functional impairment and loss of QOL, whereas unilateral amputees primarily report difficulties with coping and psychological issues. [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]…”

Vascularized Composite Allotransplant in the Realm of Regenerative Plastic Surgery

“…The Innsbruck Psychological Screening Program for Reconstructive Transplantation has been described as a tool for assessment of psychiatric health in potential VCA recipients. 25 Although national and multinational organizations such as Eurotransplant in Europe and the United Network for Organ Sharing (UNOS) provide guidelines and rules for allocation of solid organs, mandatory registries for VCA do not yet exist. Furthermore, considerations for VCA donors exceed those for SOT, with potential donors needing to fulfill requirements such as similarity of skin color, gender, and age matched to recipients for hand and face transplant.…”

Concomitant Face/Upper Extremity Allotransplantation

“…Failure of both face and hand transplants has resulted from patient noncompliance with post-operative immunosuppression protocols [3 •• , 46]. Some teams have published methods for assessment, selection and preparation of individual face or hand transplant recipients [47,48]. However, no patient selection criteria for concomitant face and hand transplantation have been suggested thus far.…”