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Related Experiment Video

Updated: Jul 14, 2026

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
10:36

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

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|May 22, 2007
PubMed
Summary

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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.

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Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
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Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation

Published on: June 13, 2025

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Last Updated: Jul 14, 2026

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
10:36

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach

Published on: May 23, 2025

Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
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Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation

Published on: June 13, 2025

  • 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.