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人手全移植:关于前6个月的报告

J M Dubernard¹, E Owen, G Herzberg

¹Service de Chirugie de la Transplantation et d'Urologie, Hôpital Edouard Herriot, Lyon, France. jean-michel.dubernard@chu-lyon.fr

Lancet (London, England)

|April 28, 1999

概括

手移植在技术上是可行的. 目前的免疫抑制有效地预防了急性排斥,提供了一个有前途的功能预后,与重建性手术相当.

科学领域:

手术创新在外科创新.
移植医学移植医学
免疫学免疫学免疫学

背景情况:

免疫抑制和肢体移植方面的进展表明,人类手部全移植的临床可行性.
之前的动物研究表明,用新型免疫抑制剂组合的四肢全移植的长期存活率.

研究的目的:

评估人类手移植的技术可行性和初始结果.
评估一种新型免疫抑制疗法的有效性,以防止排斥.

主要方法:

在一个创伤性截肢患者身上进行了单中心手部全移植.
这项手术涉及精细的剖析,骨固定,血管和神经解剖,以及微手术技术.
一个全面的免疫抑制方案,包括抗细胞球蛋白,塔克罗利斯,基酸和普雷迪尼松被管理.

主要成果:

手术成功完成,缺血时间为12.5小时.
手术后的康复没有任何事件,免疫抑制被容忍得很好.
8-9周轻微的排斥症状通过调整免疫抑制而消失,并且观察到显著的运动和感官恢复.

结论:

人手全移植在技术上是可以实现的.
目前的免疫抑制策略在预防急性排斥方面似乎有效.
功能性结果表明手部移植的预后有利.

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