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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
Unilateral hand transplant-results after 41 months
J Jablecki1, L Kaczmarzyk, A Domanasiewicz
1Subdepartment of Limb Replantation, St Hedwig Hospital, Trzebnica, Poland. jerzy.jablecki@interia.pl
Transplantation Proceedings
|February 5, 2013
Summary
This study details a successful hand transplant (HTx) in a male recipient using a female donor limb. The patient regained significant hand function and sensation, enabling daily activities and full-time employment.
Area of Science:
- Transplantation immunology
- Reconstructive surgery
- Clinical outcomes
Background:
- A young male underwent a hand transplant (HTx) 7 years after losing his limb.
- The donor limb was female, with three HLA-A, -B, -DR mismatches and negative crossmatches.
Observation:
- Maintenance immunosuppression included tacrolimus, steroids, and mycophenolate mofetil.
- At 41 months post-transplant, Semmens-Weinstein's monofilament tests showed positive results for ulnar (S3-) and median (S3+) nerves.
- Grip strength measured 5.4 kg.
Findings:
- Hand Transplant Score System (HTSS) was 93.5, Chen grade I, modified Tamai score 86, and DASH score 65.
- The patient achieved significant functional recovery, including sensation and motor skills.
- The transplanted hand allowed the patient to perform most daily activities.
Implications:
- This case demonstrates the potential for successful long-term outcomes in hand transplantation, even with immunological challenges.
- Restoration of function enables return to work and improved quality of life.
- Further research into optimizing immunosuppression and surgical techniques for hand transplantation is warranted.
