Donor-related issues in hand transplantation

The policies and procedures for solid-organ donation, under the auspices of the Organ Procurement and Transplantation Network, currently cannot be applied to hand donation, because a hand allograft is considered a tissue in the United States and is under the jurisdiction of the Food and Drug Administration. Hand transplant centers have developed their own protocols. This article discusses the unique elements of such protocols, including training and education, the consent process, the necessary recipient and donor data, donor management, and operating room procedures. Candidate listing, allocation, and oversight of hand donation in the future are also discussed.