Our Summary

This study looked at six patients who had undergone arm and hand transplants to understand the need for additional surgeries after the transplant. The researchers found that around 67% of these patients needed more surgeries after their transplants, with a total of seven surgeries involving 13 different procedures. Most of these additional surgeries were to improve the function of the hand, like nerve decompressions and tendon transfers. In some cases, surgeries were needed to fix issues like excess skin or a build-up of blood (hematoma). The researchers concluded that the need for these additional surgeries is an important factor to consider when planning for a transplant, including its cost-effectiveness.

FAQs

  1. What percentage of patients needed additional surgeries after their arm and hand transplants, according to the study?
  2. What were the common reasons for additional surgeries after a hand transplant?
  3. How does the need for additional surgeries impact the planning and cost-effectiveness of a hand transplant?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand transplant is to be prepared for the possibility of needing additional surgeries after the initial transplant. These surgeries are often aimed at improving the function of the hand and addressing any complications that may arise. It is important for patients to discuss and understand the potential need for additional surgeries with their healthcare team before undergoing a hand transplant.

Suitable For

Patients who are typically recommended for hand transplant are those who have lost one or both hands due to traumatic injury, burns, or congenital deformities. These patients must have a strong desire to regain hand function and be committed to the lifelong immunosuppressive medication regimen required to prevent rejection of the transplanted hand. Additionally, candidates for hand transplant must have a good overall health status and be psychologically stable to handle the challenges of the transplant process and recovery.

Timeline

Before hand transplant:

  1. Patient undergoes thorough evaluation to determine eligibility for transplant
  2. Patient is placed on a waiting list for a suitable donor
  3. Patient undergoes pre-transplant evaluations and tests
  4. Patient receives a call informing them of a suitable donor match
  5. Patient undergoes the hand transplant surgery

After hand transplant:

  1. Patient undergoes post-transplant care and monitoring in the hospital
  2. Patient begins rehabilitation and physical therapy to regain hand function
  3. Patient may experience complications or rejection episodes that require medical treatment
  4. Patient may need additional surgeries to improve hand function or address complications
  5. Patient continues with long-term follow-up care to monitor hand function and overall health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hand transplant?
  2. How long is the recovery process and what can I expect during this time?
  3. Will I need to take immunosuppressant medications for the rest of my life? What are the potential side effects of these medications?
  4. What is the success rate of hand transplants and what factors can influence the outcome?
  5. How will the transplant affect my daily activities, such as work, hobbies, and self-care tasks?
  6. Are there any alternatives to a hand transplant that I should consider?
  7. How often will I need to follow up with my medical team after the transplant?
  8. What kind of rehabilitation and therapy will I need after the transplant to regain function in my hand?
  9. How will the transplant impact my overall quality of life in the long term?
  10. Are there any support groups or resources available for individuals who have undergone a hand transplant?

Reference

Authors: Aravind P, Frost C, Javia V, Cooney DS, Brandacher G, Shores JT, Cooney CM. Journal: Hand (N Y). 2022 Sep;17(5):969-974. doi: 10.1177/1558944720966723. Epub 2020 Nov 16. PMID: 33190550