Our Summary

This research paper is about hand and upper-arm transplants. These types of transplants can fix extremely damaged limbs that regular surgery can’t. In the last 20 years, over 200 of these transplants have taken place globally. Out of these, 7 were between donors and receivers of different genders. However, the long-term effects of the recipient’s sex hormones and nerve growth on the physical features of the donated limb, which can vary between genders, haven’t been studied before. The researchers share a case of a hand transplant between different genders, where the hand changed to match the recipient’s gender over time.

FAQs

  1. What is hand and upper-extremity transplantation?
  2. How many vascularized composite allotransplantations have been performed worldwide in the past 20 years?
  3. What is a sex congruent transformation in hand transplantation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand transplant is to carefully follow the post-transplant therapy and rehabilitation plan to ensure optimal function and success of the transplant. This may include regular physical therapy, taking prescribed medications, and attending follow-up appointments with the transplant team. It is important to communicate any concerns or changes in symptoms to the medical team promptly.

Suitable For

Patients who are typically recommended for hand transplant are those who have suffered severe trauma or injury to their hands or upper extremities that cannot be repaired through conventional surgical techniques. This may include individuals who have lost their hands due to accidents, burns, congenital defects, or diseases. In some cases, patients with severe arthritis or other degenerative conditions may also be candidates for hand transplant.

Hand transplant is a complex and high-risk procedure, so patients must meet certain criteria to be considered for the surgery. This may include being in good overall health, having realistic expectations about the outcome of the transplant, and being willing to commit to a lifelong regimen of immunosuppressive medications to prevent rejection of the donor limb.

In the case of the intergender hand transplant described in the abstract, the recipient likely experienced a transformation of hand morphology that aligned with their own gender identity due to the effects of sex hormones and nerve regeneration. This highlights the importance of considering the psychological and emotional aspects of hand transplantation, in addition to the physical and functional benefits.

Timeline

Before hand transplant:

  1. Patient undergoes extensive medical and psychological evaluations to determine eligibility for a hand transplant.
  2. Patient meets with a transplant team to discuss risks, benefits, and expectations of the procedure.
  3. Patient is placed on a waiting list for a suitable donor hand.
  4. Donor hand is identified and matched with the recipient based on blood type, tissue compatibility, and other factors.
  5. Surgery is performed to transplant the donor hand onto the recipient’s arm.

After hand transplant:

  1. Patient undergoes intensive physical and occupational therapy to regain function and strength in the transplanted hand.
  2. Patient takes immunosuppressant medications to prevent rejection of the donor hand.
  3. Patient continues regular follow-up appointments with the transplant team to monitor progress and address any complications.
  4. Over time, nerve regeneration occurs, allowing the patient to regain sensation and fine motor control in the transplanted hand.
  5. Patient adjusts to the new hand, both physically and psychologically, and learns to use it in daily activities.
  6. Patient experiences improvements in quality of life and functionality as the hand transplant proves successful.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with a hand transplant surgery?
  2. How long is the recovery process and what kind of rehabilitation will be required?
  3. What are the long-term effects of taking immunosuppressant medications to prevent rejection of the transplanted hand?
  4. How will the transplanted hand function compared to my original hand?
  5. Will I need ongoing therapy or medical care after the surgery?
  6. What are the chances of rejection and what signs should I watch for?
  7. How will the transplanted hand impact my daily activities and quality of life?
  8. Are there any specific lifestyle changes I should make post-surgery?
  9. How successful have previous hand transplant surgeries been in terms of function and appearance?
  10. Are there any alternative treatments or therapies that I should consider before opting for a hand transplant?

Reference

Authors: Mt F, Sivakumar DK, Mohapatra D, Chittoria R. Journal: Ann Plast Surg. 2021 Feb 1;86(2):223-225. doi: 10.1097/SAP.0000000000002515. PMID: 32756244