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Hand transplantation: current challenges and future prospects

Authors Alolabi N, Augustine H, Thoma A

Received 12 July 2016

Accepted for publication 27 September 2016

Published 21 February 2017 Volume 2017:9 Pages 23—29


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Qing Yi

Noor Alolabi,1 Haley Augustine,1 Achilles Thoma1–3

1Division of Plastic Surgery, Department of Surgery, 2Surgical Outcomes Research Centre, 3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

Abstract: Over the last two decades, 113 vascularized composite allotransplantation (VCA) of the hand have been performed in 76 patients globally. The procedure that was once regarded as experimental has certainly emerged as a clinical reality with multiple centers worldwide now performing it. The psychological and physical impact of losing an upper extremity is profound. Amputees face significant challenges contributing to disability and dependence even with activities of daily living. Hand transplantation offers functions with restoring sensation, voluntary motor control, and proprioception, as well as a sense of feeling “whole” again. Along with these benefits, however, transplantation carries a significant risk profile attributed to the complications of life-long immunosuppression and possible rejection. Moreover, the procedure carries a significant financial burden to the health care system. As hand VCA is becoming more widely accepted and performed worldwide, there are still many challenges that will face its rapid growth. This review highlights some of the challenges facing hand VCA including patient selection, effect on quality of life, financial burden, functional outcomes, and complications of immunosuppression.

Keywords: hand transplantation, vascularized composite allotransplantation

A Letter to the Editor has been received and published for this article.

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