TY - JOUR
T1 - First forearm transplantation
T2 - Outcome at 3 years
AU - Schneeberger, S.
AU - Ninkovic, M.
AU - Gabl, M.
AU - Ninkovic, M.
AU - Hussl, H.
AU - Rieger, M.
AU - Loescher, W.
AU - Zelger, B.
AU - Brandacher, G.
AU - Bonatti, H.
AU - Hautz, T.
AU - Boesmueller, C.
AU - Piza-Katzer, H.
AU - Margreiter, R.
PY - 2007/7
Y1 - 2007/7
N2 - We here report on the surgical procedure, postoperative course and functional results at 3 years following the first bilateral forearm transplantation. A 41-year-old male underwent bilateral forearm transplantation on February 17, 2003. After ATG induction therapy, tacrolimus, prednisone and MMF were given for maintenance immunosuppression. At 16 months, MMF was switched to everolimus. Hand function, histology, immunohistochemistry, radiomorphology, motor and nerve conduction and somatosensory-evoked potentials were investigated at frequent intervals. A total of six rejection episodes required treatment with either steroids, basiliximab, ATG, alemtuzumab or tacrolimus dose augmentation. At 3 years, the patient is free of clinical signs of rejection despite a persisting minimal perivascular lymphocytic dermal infiltrate. No signs of myointimal proliferation in graft vessels were seen. Motor function continuously improved, resulting in satisfactory hand function. Intrinsic hand muscle function was first observed at 16 months and continues to improve. Although discrimination of hot and cold recovered, overall sensitivity remains poor. The patient is satisfied with the outcome. Bilateral forearm transplantation represents a novel therapeutic option after loss of forearms.
AB - We here report on the surgical procedure, postoperative course and functional results at 3 years following the first bilateral forearm transplantation. A 41-year-old male underwent bilateral forearm transplantation on February 17, 2003. After ATG induction therapy, tacrolimus, prednisone and MMF were given for maintenance immunosuppression. At 16 months, MMF was switched to everolimus. Hand function, histology, immunohistochemistry, radiomorphology, motor and nerve conduction and somatosensory-evoked potentials were investigated at frequent intervals. A total of six rejection episodes required treatment with either steroids, basiliximab, ATG, alemtuzumab or tacrolimus dose augmentation. At 3 years, the patient is free of clinical signs of rejection despite a persisting minimal perivascular lymphocytic dermal infiltrate. No signs of myointimal proliferation in graft vessels were seen. Motor function continuously improved, resulting in satisfactory hand function. Intrinsic hand muscle function was first observed at 16 months and continues to improve. Although discrimination of hot and cold recovered, overall sensitivity remains poor. The patient is satisfied with the outcome. Bilateral forearm transplantation represents a novel therapeutic option after loss of forearms.
KW - Composite tissue
KW - Forearm
KW - Hand transplantation
KW - Outcome
KW - Transplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=34250221084&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2007.01837.x
DO - 10.1111/j.1600-6143.2007.01837.x
M3 - Article
C2 - 17511764
AN - SCOPUS:34250221084
SN - 1600-6135
VL - 7
SP - 1753
EP - 1762
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 7
ER -