Our Summary

This research paper is about the increasingly popular procedure of hand and upper extremity transplantation (HUET). This type of transplant involves multiple tissue types and is often the best option for serious injuries where traditional reconstruction can’t restore the hand’s appearance and function. Despite the promising results in terms of function, the drugs used to prevent the body from rejecting the transplant can have serious side effects, which is a significant issue as this type of transplant isn’t life-saving. As more transplants are being done and patients are living longer, it’s important to study potential long-term issues, like chronic rejection. The article will discuss the current state of HUET, looking at data on transplant survival, motor and sensory function, as well as the drugs used to suppress the immune system. It will also discuss what these findings mean for the future of this type of transplant.

FAQs

  1. What is hand and upper extremity transplantation (HUET)?
  2. What are the potential side effects of the drugs used to prevent the body from rejecting the hand transplant?
  3. What are the current findings regarding HUET and what do they mean for the future of this type of transplant?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand transplant is to carefully follow the prescribed medication regimen to prevent rejection of the transplant. It’s crucial to attend all follow-up appointments and communicate any changes or concerns with your healthcare team. Additionally, participating in physical therapy and rehabilitation programs can help improve function and mobility of the transplanted hand. Being diligent about hand hygiene and avoiding activities that may put the hand at risk of injury can also help ensure the long-term success of the transplant.

Suitable For

Patients who are typically recommended for hand transplant include:

  1. Individuals who have suffered severe trauma to the hand or upper extremity, resulting in significant loss of function and appearance.

  2. Patients who have undergone multiple failed reconstructive surgeries and are still experiencing limited function and mobility in the affected hand.

  3. Individuals with congenital abnormalities or deformities that severely impact the function and appearance of the hand.

  4. Patients with debilitating conditions such as severe arthritis or paralysis that significantly impair hand function and quality of life.

  5. Individuals who are motivated and committed to the extensive rehabilitation process and lifelong medication regimen required after a hand transplant.

  6. Patients who have realistic expectations about the risks and benefits of hand transplantation and are willing to undergo the necessary evaluations and counseling before the procedure.

Overall, hand transplant is a complex and high-risk procedure that is typically reserved for patients with significant hand injuries or conditions that cannot be effectively treated through traditional means. It is important for patients to be thoroughly evaluated by a multidisciplinary team of experts to determine their eligibility for hand transplantation and to understand the potential risks and benefits of the procedure.

Timeline

Before hand transplant:

  1. Patient undergoes extensive medical evaluations to determine if they are a suitable candidate for a hand transplant.
  2. Patient is placed on a waiting list for a suitable donor hand.
  3. Once a donor hand is found, the transplant surgery is performed, which can take several hours.
  4. Patient begins a regimen of immunosuppressant drugs to prevent rejection of the transplant.
  5. Patient undergoes extensive physical therapy and rehabilitation to regain function in the transplanted hand.

After hand transplant:

  1. Patient continues to take immunosuppressant drugs to prevent rejection of the transplant.
  2. Patient undergoes regular check-ups and monitoring to assess the success of the transplant.
  3. Patient continues with physical therapy and rehabilitation to improve function in the transplanted hand.
  4. Over time, the patient may experience improvements in motor and sensory function in the transplanted hand.
  5. Potential long-term issues, such as chronic rejection, are monitored and managed by healthcare providers.

It is important for patients considering a hand transplant to be aware of the potential risks and challenges associated with the procedure, as well as the long-term commitment to post-transplant care.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hand transplant surgery?
  2. How long does the recovery process typically take, and what kind of rehabilitation will be needed?
  3. What are the success rates of hand transplant surgeries, and what factors can affect the outcome?
  4. What kind of medications will I need to take to prevent rejection of the transplant, and what are the potential side effects of these medications?
  5. How will the transplant affect my daily life and activities, such as work, hobbies, and relationships?
  6. How often will I need to follow up with my doctor post-transplant, and what kind of monitoring will be required?
  7. Are there any alternative treatments or options to consider before proceeding with a hand transplant?
  8. How long do hand transplants typically last, and what are the chances of rejection or complications in the long term?
  9. What kind of support system will I need post-transplant, and what resources are available for patients undergoing this procedure?
  10. What are the potential emotional and psychological impacts of undergoing a hand transplant, and what kind of counseling or support is available for patients?

Reference

Authors: Shores JT, Malek V, Lee WPA, Brandacher G. Journal: J Mater Sci Mater Med. 2017 May;28(5):72. doi: 10.1007/s10856-017-5880-0. Epub 2017 Mar 30. PMID: 28361279