Article
Allogenic upper extremity transplantations – opportunities and limitations
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Published: | February 6, 2020 |
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Objectives/Interrogation: Two decades ago the first successful hand transplantation has kindled the development of previously unthinkable reconstructive and restorative surgical options. Since then more than 100 of these vascularized composite limb allotransplantations (VCA) have been performed. VCA has moved from an experimental approach to a sound surgical option for patients with upper limb amputations.
Methods: Cumulative data from the international cohort suggest adequate functional and aesthetic outcomes. Patient reported quality of life after these interventions is also favourable.
The remaining major limitation towards broader application is the need for continuous life-long immunosuppression. Despite advancements in terms of immunosuppressive protocols, the related infectiology, metabolic, and malignant side effects still remain.
Results and Conclusions: Allogenic limb transplantation is a good option for some amputated patients, although not all. Careful selection and individual risk-benefit evaluation is mandatory prior to considering this novel therapeutic option.