Evaluating whether to have a hand transplant
Before you can receive a hand transplant, you should carefully consider the risks of the procedure and whether you can be committed to intense follow-up care that will last the rest of your life. You should also consider what benefits you hope to gain from a hand transplant. Post-transplant care includes:
- Regular appointments with transplant doctors and surgeons
- Regular physical therapy
- Taking immunosuppressant medications daily and managing the medications' side effects for as long as you have the donor hands
- Follow-up care with your primary care doctor for routine health screenings
You'll be evaluated by a transplant team. People with amputation at the midupper arm or below may be considered for transplant. To be considered for a hand transplant, candidates must:
- Pass a comprehensive physical exam that includes X-rays, blood tests and other measures of physical health
- Pass a mental and emotional health evaluation that examines coping skills, family and social support, and ability to manage post-transplant care
- Have no history of chronic nerve conditions, such as peripheral neuropathy
- Have no serious medical problems, such as diabetes, kidney disease, heart disease or untreatable cancers
- Have had no recent serious infections
- Be nonsmokers
- Not abuse alcohol or illegal drugs
- Complete a financial evaluation of post-transplant care expenses with a member of the transplant team
Getting ready for your hand transplant
Once you're approved for a hand transplant, you'll be placed on a waiting list for a donor hand or hands. Your wait time can be unpredictable, since it's usually not known when a donor hand or hands that will match your needs will be available.
In the meantime, you should prepare as much as possible for a transplant. Preparations include:
June 24, 2011
- Transplant clinic visits. You'll need periodic appointments with your transplant team for blood tests and ongoing evaluations of your transplant readiness.
- Strengthening exercises, if recommended. Physical therapists may work with you to increase the strength and flexibility in your arms before your transplant.
- Arrange for travel and lodging. Your transplant team will ask that you stay at a location that's within 10 hours of travel time to the hospital where you'll have your transplant. Following your transplant, you'll usually need to stay near your transplant team for several months. Your transplant team may have recommendations for long-term lodging if you need it.
- Communicate with your transplant team. If you have any changes to your medical care, including changing medications, having a blood transfusion, or being diagnosed with a chronic medical condition, let your transplant team know immediately. Also be sure to communicate any changes to your address, phone number or family contact information.
- Barbara Woodward Lips Patient Education Center. Hand and arm transplantation. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2010.
- Information for potential hand transplant patients. Composite Tissue Allotransplantation. http://www.handtransplant.com/TheProcedure/InfoforPotentialPatients/tabid/103/Default.aspx. Accessed Jan. 12, 2011.
- Petruzzo P, et al. The International Registry on Hand and Composite Tissue Transplantation. Transplantation. 2010;90:1590.
- Lanzetta M, et al. Second report (1998-2006) of the International Registry of Hand and Composite Tissue Transplantation. Transplant Immunology. 2007;18:1.
- Kaufman CL, et al. A new option for amputees: Transplantation of the hand. Journal of Rehabilitaion Research and Development. 2009;46:395.
- Cendales L, et al. Implementation of vascularized composite allografts in the United States: Recommendations from the ASTS VCA Ad Hoc Committee and the Executive Committee. American Journal of Transplantation. 2011;11:13.