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Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database.

Publication ,  Journal Article
Hein, RE; Ruch, DS; Klifto, CS; Leversedge, FJ; Mithani, SK; Pidgeon, TS; Richard, MJ; Cendales, LC
Published in: Am J Transplant
May 2020

Hand transplantation is the most common application of vascularized composite allotransplantation (VCA). Since July 3, 2014, VCAs were added to the definition of organs covered by federal regulation (the Organ Procurement and Transplantation Network (OPTN) Final Rule) and legislation (the National Organ Transplant Act). As such, VCA is subject to requirements including data submission. We performed an analysis of recipients reported to the OPTN to have received hand transplantation between 1999 and 2018. Forty-three patients were identified as having been listed for upper extremity transplantation in the United States. Of these, 22 received transplantation prior to July 3, 2014 and 10 from then to December 31, 2018. Of patients transplanted after 2014, posttransplant functional scores included a decrease in Disabilities of the Arm, Shoulder and Hand questionnaire in 3 of 10 patients, Carroll test scores ranging from 9 to 60 of 99, and monofilament testing with protective sensation achieved in 4 of 6 patients. Complications included rejection in nine recipients with Banff scores from II-IV. One patient experienced graft failure 5 days after transplantation. Of the remaining patients, two were reported as receiving monotherapy and seven receiving dual or triple immunosuppression therapy. The inclusion of VCA in the OPTN Final Rule standardized parameters for safe implementation and data collection.

Duke Scholars

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

May 2020

Volume

20

Issue

5

Start / End Page

1417 / 1423

Location

United States

Related Subject Headings

  • Vascularized Composite Allotransplantation
  • United States
  • Tissue and Organ Procurement
  • Surgery
  • Organ Transplantation
  • Humans
  • Hand Transplantation
  • Databases, Factual
  • 3204 Immunology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Hein, R. E., Ruch, D. S., Klifto, C. S., Leversedge, F. J., Mithani, S. K., Pidgeon, T. S., … Cendales, L. C. (2020). Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database. Am J Transplant, 20(5), 1417–1423. https://doi.org/10.1111/ajt.15704
Hein, Rachel E., David S. Ruch, Christopher S. Klifto, Fraser J. Leversedge, Suhail K. Mithani, Tyler S. Pidgeon, Marc J. Richard, and Linda C. Cendales. “Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database.Am J Transplant 20, no. 5 (May 2020): 1417–23. https://doi.org/10.1111/ajt.15704.
Hein RE, Ruch DS, Klifto CS, Leversedge FJ, Mithani SK, Pidgeon TS, et al. Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database. Am J Transplant. 2020 May;20(5):1417–23.
Hein, Rachel E., et al. “Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database.Am J Transplant, vol. 20, no. 5, May 2020, pp. 1417–23. Pubmed, doi:10.1111/ajt.15704.
Hein RE, Ruch DS, Klifto CS, Leversedge FJ, Mithani SK, Pidgeon TS, Richard MJ, Cendales LC. Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database. Am J Transplant. 2020 May;20(5):1417–1423.
Journal cover image

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

May 2020

Volume

20

Issue

5

Start / End Page

1417 / 1423

Location

United States

Related Subject Headings

  • Vascularized Composite Allotransplantation
  • United States
  • Tissue and Organ Procurement
  • Surgery
  • Organ Transplantation
  • Humans
  • Hand Transplantation
  • Databases, Factual
  • 3204 Immunology
  • 3202 Clinical sciences