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Outcomes after hand and upper extremity transplantation.
Jaimie T Shores1, Veronika Malek1,2, W P Andrew Lee1
1Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Journal of Materials Science. Materials in Medicine
|April 1, 2017
Summary
Hand and upper extremity transplantation (HUET) offers reconstructive benefits for severe injuries. However, long-term immunosuppression and chronic rejection remain significant challenges for this life-changing procedure.
Area of Science:
- Transplantation immunology
- Reconstructive surgery
- Vascularized composite allotransplantation (VCA)
Background:
- Hand and upper extremity transplantation (HUET) is the most common procedure in vascularized composite allotransplantation (VCA).
- VCA offers a treatment option for severe injuries unresponsive to conventional reconstruction.
- Increasing HUET procedures necessitate evaluation of long-term outcomes and risks.
Purpose of the Study:
- To review the current status of HUET.
- To summarize outcomes including graft survival, motor/sensory function, and immunosuppression.
- To discuss the future implications for VCA.
Main Methods:
- Literature review of HUET outcome data.
- Analysis of graft survival rates.
- Assessment of functional recovery and immunosuppressive strategies.
Main Results:
- Encouraging functional outcomes reported for HUET.
- Significant concerns persist regarding immunosuppressive side effects.
- Chronic rejection is a potential long-term complication requiring further investigation.
Conclusions:
- HUET represents a significant advancement in reconstructive transplantation.
- Balancing functional gains against immunosuppression risks is crucial.
- Further research is needed to address long-term VCA challenges, including chronic rejection.