Hand Transplantation-Risks and Benefits.

Area of Science:

• Transplantation Surgery
• Reconstructive Surgery
• Medical Ethics

Background:

• Composite tissue allotransplantation (CTA) represents a significant advancement in reconstructive surgery.
• Over 100 hand allotransplantation procedures have been performed globally, offering a potential solution for amputees.

Purpose of the Study:

• To provide a comprehensive overview of the current landscape of hand allotransplantation.
• To elucidate the technical aspects, associated risks, and potential benefits of this procedure.

Main Methods:

• A systematic literature search was conducted on PubMed from October 2018 to March 2019.
• Keywords included "Hand transplantation," "Composite tissue allotransplantation," "Functional outcomes," "Immunosuppression," "Hand prosthetics," and "Ethics."
• Seventy-two relevant papers published between 1995 and 2018 were evaluated.

Main Results:

• Technical factors such as team coordination and surgical technique are critical for successful hand allotransplantation.
• Patients require lifelong immunosuppressive therapy, posing risks of toxicity and infection.
• Successful procedures can restore fine motor skills and enhance patient independence.

Conclusions:

• Hand allotransplantation is a viable option for select amputees, but careful patient selection is crucial, considering the benefits of advanced prosthetics.
• Ongoing research is needed to fully ascertain the long-term benefits of CTA.
• The non-life-saving nature of the procedure fuels ethical discussions regarding its risks and benefits.