Related Experiment Video
Updated: Jul 14, 2026
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Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
First forearm transplantation: outcome at 3 years
S Schneeberger1, M Ninkovic, M Gabl
1Department of General and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria. stefan.schneeberger@i-med.ac.at
Summary
This study details the first bilateral forearm transplant, showing improved hand function and patient satisfaction after three years. Despite rejection episodes, the patient achieved significant motor recovery, demonstrating a viable therapeutic option for forearm loss.
Area of Science:
- Transplantation immunology
- Limb reconstructive surgery
- Immunosuppression protocols
Background:
- Bilateral forearm transplantation is a complex procedure for limb loss.
- Establishing long-term graft function and managing immunosuppression are critical challenges.
Observation:
- A 41-year-old male received bilateral forearm transplants in 2003.
- The patient underwent induction therapy with anti-thymocyte globulin (ATG) and maintenance immunosuppression with tacrolimus, prednisone, and mycophenolate mofetil (MMF), later switched to everolimus.
- Graft function was monitored through hand function tests, histology, and electrophysiological studies.
Findings:
- The patient experienced six rejection episodes, managed with various immunosuppressive agents and dose adjustments.
- At three years post-transplant, the patient showed no clinical signs of rejection, with only minimal dermal infiltrate observed.
- Significant improvement in motor function and intrinsic hand muscle function was noted, leading to satisfactory hand function, though sensory recovery remained incomplete.
Implications:
- Bilateral forearm transplantation is a viable therapeutic option for patients with forearm loss.
- Effective management of rejection episodes and immunosuppression is crucial for successful long-term outcomes.
- Continued research into optimizing immunosuppression protocols and enhancing functional recovery is warranted.
