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Updated: Jun 23, 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
Bilateral hand transplantation: result at 20 months
P C Cavadas1, L Landin, J Ibañez
1Clinica Cavadas, Valencia, Spain. pcavadas@clinicacavadas.es
The Journal of Hand Surgery, European Volume
|April 28, 2009
Summary
This study details a bilateral hand allotransplantation for a patient with a 28-year history of radiocarpal amputations. The procedure achieved good functional outcomes at 20 months, despite two acute rejection episodes.
Area of Science:
- Surgical innovation in reconstructive transplantation.
- Immunosuppression protocols in organ transplantation.
- Long-term functional outcomes of allotransplantation.
Background:
- A 47-year-old female underwent bilateral hand allotransplantation in November 2006, 28 years after radiocarpal amputations.
- The case highlights the technical complexities and long-term considerations in composite tissue allotransplantation.
Observation:
- Alemtuzumab induction followed by triple therapy (tacrolimus, mycophenolate mofetil, prednisone) was employed for immunosuppression.
- The patient experienced two acute rejection episodes, successfully managed with steroid treatment.
- Co-morbidities included a factitious visual disorder and a facial basal cell carcinoma.
Findings:
- At 20 months post-transplantation, the patient demonstrated good functional recovery.
- The Hand Registry Functional Score was 69, and the Disabilities of the Arm, Shoulder and Hand (DASH) score was 19.
Implications:
- This case demonstrates the feasibility of successful bilateral hand allotransplantation in patients with long-standing amputations.
- Effective immunosuppression and vigilant monitoring are crucial for managing rejection and potential complications.
- The findings contribute to understanding the long-term functional results and challenges in hand allotransplantation.
