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From Auto- to Allotransplantation: Immunomodulatory Protocol for Hand and Arm Transplantation
W P Andrew Lee1, Jaimie T Shores1, Gerald Brandacher1
1Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Aim:
To achieve a favorable risk-benefit balance for hand transplantation, an immunomodulatory protocol was developed in the laboratory and translated to clinical application.
Methods:
Following donor bone marrow infusion into transplant recipients, hand and arm allografts have been maintained on low-dose tacrolimus monotherapy.
Results:
Good-to-excellent functional recovery has been achieved in patients compliant with medication and therapy, thus restoring autonomous and productive lives.
Conclusion:
The risk-benefit balance can be tilted in favor of the hand transplant recipients by using an immunomodulatory protocol with minimum immunosuppression.
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