The first Belgian hand transplantation--37 month term results

The first Belgian hand transplant was a 22 year-old man with a traumatic amputation of his dominant hand at the junction of the middle and distal thirds of the forearm. The donor and recipient had three HLA mismatches. The cross-match was negative. The total ischaemic time was slightly over 6 hours. Immunosuppression included antithymocyte globulins at induction and tacrolimus, mycophenolate mofetil and prednisolone as induction and maintenance therapy. There has been no episode of rejection. The only significant complications, except for transient hyperglycaemia, were psychological. At 37 months post-transplantation, the patient has fully incorporated his transplant into his self-image and is back at work. He has good sensibility (two-point discrimination of 6mm at the thumb and index finger pulps), acceptable wrist and finger motion with functioning intrinsic muscles. According to Chen's criteria, the result is good to excellent.