Allogeneic hand transplantation and rehabilitation of hand function: a 10-year follow-up study

The purpose of this study is to present the long-term outcomes of allogenic hand transplantations performed at our centre. Between January 2001 and October 2002, five allogeneic limb transplantations were performed in three patients (two bilateral forearm and one left hand transplantation). Donors and recipients were matched for blood types (ABO/Rh) and had at least two human leukocyte antigen (HLA) matches. A comprehensive rehabilitation plan integrating preoperative, intraoperative and postoperative management was developed for each patient. After 10 years, all transplantations were performed successfully without complications. As of 2014, all grafts were viable. The transplanted hands showed palmate morphology, perceived superficial pain and tactile sensations, and the static two-point discrimination ranged from 2·5 to 4·0 mm. Chronic rejection at 4 years after surgery reduced hand function in case 2. Grip strength ranged from 3 kg (case 2) to 16-18 kg (case 1) to 41-43 kg for case 3. Lifting strength ranged from 3 kg (case 2) to 21-23 kg (case 1) to 47-51 kg for case 3. They lead a completely independent life. In summary, hand function following allogeneic limb transplantation allows the ability to perform tasks of daily living.