First Polish Hand Allograft - 6-Month Report

• Authors: Jerzy Jabłecki , Leszek Kaczmarzyk , Dariusz Patrzałek , Adam Domanasiewicz , Maciej Paruzel , Adam Chełmoński , Janusz Kaczmarzyk
• Languages of publication: EN

Abstracts

EN

The transplant recipient is a 32 year-old man who lost his right, dominant upper limb on the level of the midpoint of his forearm in an accident 14 years ago. After a comprehensive pretransplantation evaluation and informed consent process he received a transplant of the right forearm, matched for size and skin tone, of a brain-dead man aged 47. The donor's limb was amputated at the elbow and irrigated with UW solution. We dissected the donor and recepient limbs simultaneously. Appropriate lengths of anatomical structures were matched. Bone fixation was performed with Rush pins, without bony transplants; the muscles were anastomosed in layers and the skin wound was closed without a skin transplant. The cold ischemia time was 10.5 hours. Immunosuppresion included simulect, tacrolimus, mycophenolic acid, and prednisone. Maintanance therapy included tacrolimus (15 ng/ml), mycophenolic acid, and encorton.There were no intraoperative or early postoperative complications. No episodes of rejection were observed. Immunosupression was well tolerated. The intensive physiotherapy led to satisfactory progress of motor function recovery. Reinnervation was excellent, and after 6 months, Tinel's sign was present over 40% of the respective lengths of the median and ulnar nerves. Follow-up included routine post-transplant laboratory tests, skin biopsies, bacteriological tests, and physiotherapy.

Keywords

EN

hand transplant; immunotherapy; physiotherapy; functional evaluation

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2007
• Volume: 79
• Issue: 3
• Pages: 232-238

Dates

published

1 - 3 - 2007

online

24 - 9 - 2007

Contributors

author

Jerzy Jabłecki

• Department of General Surgery, Subdepartment of Limb Replantation, St. Hedwig Hospital, Trzebnica

author

Leszek Kaczmarzyk

• Department of General Surgery, Subdepartment of Limb Replantation, St. Hedwig Hospital, Trzebnica

author

Dariusz Patrzałek

• Department of General, Vascular and Transplantological Surgery, Piastów Śląskich Medical University, Wrocław

author

Adam Domanasiewicz

• Department of General Surgery, Subdepartment of Limb Replantation, St. Hedwig Hospital, Trzebnica

author

Maciej Paruzel

• Department of General Surgery, Subdepartment of Limb Replantation, St. Hedwig Hospital, Trzebnica

author

Adam Chełmoński

• Department of General Surgery, Subdepartment of Limb Replantation, St. Hedwig Hospital, Trzebnica

author

Janusz Kaczmarzyk

• Department of General Surgery, Subdepartment of Limb Replantation, St. Hedwig Hospital, Trzebnica

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Identifiers

DOI

10.2478/v10035-007-0035-5