Unlike solid-organ transplantation, hand transplantation involves several different types of tissues - skin, muscle, tendon, bone, cartilage, fat, nerves and blood vessels. This kind of multiple-tissue transplant is known as "composite tissue allotransplantation" (CTA).
Hand transplantation is a complex procedure that involves bone fixation and the repair of the major arteries, veins, nerves, tendons and skin. Surgery can last from 8-to-12 hours and requires highly specialized surgeons working in coordinated teams.
A key element to the success of the procedure is the selection of the donor limb. In addition to meeting the prerequisites for the selection of other organs, care is taken to match the donor hand size, skin color and tone, gender and ethnicity to that of the recipient. Matching of suitable donor limbs is coordinated by One Legacy. For more information about One Legacy, visit www.onelegacy.org.
As with any other type of transplantation such as heart, liver, lung, kidney or pancreas, patients who undergo a limb transplant must take immunosuppressive medications to prevent rejection of the graft. Patients also will undergo an intensive rehabilitation regimen to restore function to the transplanted hand. Rehabilitation therapy generally begins 48 hours after surgery, and is critical for functional success of the procedure.
The patient also will undergo periodic biopsies and lab evaluations. Patients participating in the UCLA Hand Transplantation Program will need to remain in the Los Angeles region for initial post-operative period to be carefully monitored.