Journal of Hand Surgery (European Volume)

 

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Journal of Hand Surgery (European Volume), Vol. 32, No. 1, 2-17 (2007)
DOI: 10.1016/j.jhsb.2006.09.008
© 2007 The British Society for Surgery of the Hand

Article

Hand Transplantation: The State-of-the-Art

F. SCHUIND, D. ABRAMOWICZ and S. SCHNEEBERGER

From the Service d’Orthopédie-Traumatologie and Service de Néphrologie, Cliniques Universitaires de Bruxelles, Hôpital Erasme, 808 route de Lennik, B-1070, Brussels, Belgium and Department of Transplantation Surgery, University Hospital, Anichstrasse 35, Innsbruck, Austria

Correspondence: Frédéric Schuind, Service d’Orthopédie-Traumatologie, Hôpital Erasme, Route de Lennik 808, 1070 Bruxelles, Belgium E-mail:Fschuind{at}ulb.ac.be

The feasibility of hand transplantation has been demonstrated, both surgically and immunologically. Levels of immunosuppression comparable to regimens used in solid organ transplantation are proving sufficient to prevent graft loss. Many patients have achieved discriminative sensibility and recovery of intrinsic muscle function. In addition to restoration of function, hand transplantation offers considerable psychological benefits. The recipient’s pre-operative psychological status, his motivation and his compliance with the intense rehabilitation programme are key issues. While the induction of graft specific tolerance represents a hope for the future, immunosuppression currently remains necessary and carries significant risks. Hand transplantation should, therefore, only be considered a therapeutic option for a carefully selected group of patients.

Key Words: hand transplantation • amputation • immunosuppression


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