Hand transplantation--Polish program

Area of Science:

• Reconstructive surgery
• Transplantation medicine
• Limb surgery

Background:

• Hand transplantations (HTs) are complex procedures performed at specialized centers.
• The Subdepartment of Replantation of Limbs in Trzebnica, Poland, meets the requirements for a transplantation program.
• This study presents the center's initial 3-year experience with hand transplantation.

Purpose of the Study:

• To present the initial experience and outcomes of hand transplantation at a specialized center in Poland.
• To evaluate the feasibility and results of hand transplantation in patients with severe hand amputations.

Main Methods:

• A waiting list was established based on standard inclusion criteria.
• 13 potential candidates were identified from 52 evaluated individuals over 4 years.
• Three hand transplantations were performed between 2006 and 2008 in male patients with single or double hand amputations, with varying times elapsed since amputation.

Main Results:

• The first patient achieved 63% finger motion and good functional scores (SF-36: 50, DASH: 95, CFSS: 84), with one mild rejection episode.
• The second hand transplantation failed.
• The third patient demonstrated 80% finger motion and restored fingertip sensitivity, with no rejection episodes.

Conclusions:

• The positive outcomes from two of the three hand transplantations support the continuation of the program.
• Hand transplantation is a viable option for select patients with severe hand loss.
• Further experience is needed to optimize outcomes and manage potential complications.