Technique for Rapid Hand Transplant Donor Procurement Through the Elbow

Area of Science:

• Transplantation Surgery
• Surgical Techniques
• Organ Procurement

Background:

• Hand and distal forearm allotransplantation has evolved into a viable treatment for bilateral upper extremity amputation over the past two decades.
• Despite advancements, detailed technical reports on donor arm procurement remain scarce.
• This study addresses the need for efficient donor arm procurement techniques.

Purpose of the Study:

• To detail a technique for rapid donor arm procurement through the elbow for mid to distal forearm hand allografts.
• To streamline the process of donor arm procurement for multi-organ donors.
• To reduce the time required for hand allograft procurement.

Main Methods:

• Nine arm procurements were conducted on deceased tissue-only donors.
• A fishmouth incision was utilized through the lateral and medial epicondyles.
• Key steps included identification of neurovascular structures and elbow joint disarticulation.

Main Results:

• Procurement through the elbow offers simplified anatomy and avoids bone cutting.
• This method allows for procurement, flushing, and packaging within 20 minutes.
• The technique proved efficient in both bilateral and unilateral cases.

Conclusions:

• Elbow procurement is a straightforward procedure that minimizes time for hand allograft acquisition.
• This technique enhances efficiency for multi-organ donors.
• Successful hand and upper extremity allotransplantation relies on team coordination and surgical preparation.