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Home > Hand/Arm Transplant > Limitations

Limitations

 

Dr. Dumanian, Chief of Plastic Surgery, explains the differences between distal and high amputation transplantations.

 
 

The hand/arm transplant will not function exactly like your upper limb before your injury or loss.

  • Hand/arm transplant recipients do not gain feeling or function immediately after surgery. Return of feeling and function in the hand/arm after transplant surgery can take months or years.
  • Not everyone will have the same success in regaining hand/arm function or accepting the hand/arm as part of their body and identity.
  • Recipients of below-elbow hand/arm transplants regain sensory and motor function faster than recipients of above-elbow hand/arm transplants. This is because the nerves have a longer distance to grow back and reach the hand in above-elbow transplants than in below-elbow transplants.¹
  • If hand/arm transplant recipients are unable to accept the transplant as part of their own body and self-identity, they may stop taking their anti-rejection medicines, which can lead to the loss of the transplant.2,3
  • Upper limb function is difficult to predict and depends on:
    • The level of the transplant (e.g., below-elbow versus an above-elbow transplant)
    • The health of the recipient
    • The recipient’s participation in and adherence to their recovery regimen (medicine, physical and occupational therapy).
  • Getting a hand/arm transplant will not make a person’s other problems go away. It is important that transplant recipients continue to get regular care after the transplant to address other physical or psychological health issues.
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“I could do almost everything with my prosthetics. Now I can’t do anything.”
- Jeff Kepner, 38-year-old man who received a double hand/arm transplant

 
 

References

Sources

  1. Shores JT, Brandacher G, Lee WPA. Hand and Upper Extremity Transplantation: An Update of Outcomes in the Worldwide Experience. Plast Reconstr Surg 2015;135(2):351e-360e.  

  2. Kumnig M, Jowsey-Gregoire SG, Moreno E, et al. An Overview of Psychosocial Assessment Procedures in Reconstructive Hand Transplantation. Transplant International 2014;27(5):417-427.

  3. Petruzzo P, Lonzetta M, Dubernard JM, et al. The International Registry on Hand and Composite Tissue Transplantation. Transplantation 2008; 86(4): 487-492.