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Weigh All Options
Have You Thought About All Treatment Options?
- Some people with upper limb loss adapt well to their amputation physically and psychologically.1,2
- Some may prefer using a prosthesis or some may prefer hand/arm transplantation due to their personal preferences and treatment goals.1,2
- Because there are different treatment options available for people with upper limb loss, each person must review their options and choose based on their personal situation.3
- Hand/arm transplantation does not need to occur immediately after amputation. For an eligible candidate, transplantation can take place when the person is ready and after they have completed the evaluation process.
Have You Weighed the Benefits and the Risks of Each Treatment Option?
- People decide to undergo hand/arm transplantation to regain physical function, recover sense of touch, and improve body image/self-image and interpersonal relationships.3,4
- It is important to keep in mind that hand/arm transplantation is not a lifesaving procedure. Rather, it is a life-enhancing procedure that may improve quality of life, but there are risks and the potential for failure.5-7
- It is important for people with upper limb loss to learn about the benefits and risks of hand/arm transplantation and other treatment options available to them, and think about what matters most to them and their motivations for their preferred treatment option.5
Click Below for More Videos
Videos of Health Care Professionals
Dr. Dumanian, Chief of Plastic Surgery, talks about questions that patients can ask the transplant surgeon about hand/arm transplantation before making a decision.
Dr. Scott Tintle, Chief of Hand Surgery, discusses hand/arm transplantation for military personnel.
Dr. Scott Tintle, Chief of Hand Surgery, talks about the factors military personnel should consider when thinking about hand/arm transplantation.
Dr. Dumanian, Chief of Plastic Surgery, describes how the process of someone accepting their limb loss can factor into decision making about treatment options.
David Rotter, Prosthetist, gives his opinion about the pros and cons of hand/arm transplantation.
David Rotter, Prosthetist, talks about prosthetic devices and how to address patients' treatment goals.
Dr. Scott Tintle, Chief of Hand Surgery, discusses treatment options for people with upper limb loss.
Dr. Dumanian, Chief of Plastic Surgery, discusses the risks and benefits of treatment options for upper limb loss.
Joe Butkus, UE Transplant Occupational Therapist, talks about goals of military personnel when seeking treatment after amputation.
Joe Butkus, UE Transplant Occupational Therapist, compares treatment options for upper limb loss.
Videos of Hand/Arm Transplant Recipients and People with Limb Loss
Mr. Vazquez, with unilateral, above-elbow limb loss (3 years after amputation), discusses why he does not want a hand/arm transplant.
Mr. Lund, bilateral upper limb transplant recipient (5 years after transplantation), describes how he weighed the benefits and the risks of hand/arm transplantation.
Mr. White, with unilateral, below-elbow limb loss (6 years after amputation), talks about his current prosthetic use and what he hopes to gain from hand/arm transplantation.
Mr. Cicero, with unilateral, above elbow limb loss (12 years after amputation), talks about how the risks of a hand/arm transplant outweigh the benefits for him.
Mr. Pollock, a bilateral, upper limb transplant recipient (11 ½ years after transplantation), recalls his experiences with his myoelectric prosthesis.
Ms. Skinner, with unilateral, below-elbow limb loss (5 years after amputation), wonders what the adjustment period for hand/arm transplant recipients is like.
Ms. Carter, with bilateral, below-elbow limb loss (11 years after amputation), talks about her willingness to consider getting a hand/arm transplant.
Mr. Vazquez, with unilateral, above-elbow limb loss (3 years after amputation), talks about his concerns about hand/arm transplantation.
Mr. White, with unilateral, below-elbow limb loss (6 years after amputation), explains why he decided to pursue hand/arm transplant.
Mr. St. Onge, with bilateral, below-elbow limb loss (21 years after amputation), describes his perspective on getting a hand/arm transplant for himself.
Mr. Cicero, with unilateral, above elbow limb loss (12 years after amputation), outlines concerns he has about getting a hand/arm transplant.
Ms. Skinner, with unilateral, below-elbow limb loss (5 years after amputation), explains her current thoughts on getting a hand/arm transplant.
Ms. Skinner, with unilateral, below-elbow limb loss (5 years after amputation), reflects on how prostheses can be used as optional “tools”, but a hand/arm transplant is not optional once you have it.
Ms. Hill, with unilateral, above-elbow limb loss (6 years after amputation), talks about how she would have gotten a hand/arm transplant if she could do things over again.
Mr. White, with unilateral, below-elbow limb loss (6 years after amputation), talks about the benefits and functions he wants to regain after receiving a hand/arm transplant.
Mr. St. Onge, with bilateral, below-elbow limb loss (21 years after amputation), talks about the importance of exploring all options when considering a hand/arm transplant.
Mr. Pollock, a bilateral, upper limb transplant recipient (11 ½ years after transplantation), explains his views on benefits outweighing the risks of hand/arm transplantation.
Ms. Skinner, with unilateral, below-elbow limb loss (5 years after amputation), discusses what would make a hand/arm transplant worthwhile for her.
Ms. Carter, with bilateral, below-elbow limb loss (11 years after amputation), comments on what would change her mind about getting a hand/arm transplant.
References
Sources
Benedict JL. Vascularized Composite Allotransplantation. In: Weisstub DN, Cooley DR, eds. A Revised Consent Model for the Transplantation of Face and Upper Limbs: Covenant Consent. Cham, Switzerland: Springer, 2017: Ch 2.
Klapheke MM, Marcell C, Taliaferro G, et al. Psychiatric Assessment of Candidates for Hand Transplantation. Microsurgery: Official Journal of the International Microsurgical Society and the European Federation of Societies for Microsurgery 2000;20(8):453-457.
Kumnig M, Jowsey-Gregoire SG, Rumpold G, et al. The Psychological Assessment of Candidates for Reconstructive Hand Transplantation. Transplant International 2012;25(5):573-585.
Jensen SE, Butt Z, Heinemann AW, et al. Perceptions of the Risks and Benefits of Upper Limb Transplantation Among Individuals with Upper Limb Amputations. Plastic and Reconstructive Surgery 2014;134(5):979-987.
Dumont M, Sann L, Gazarian A. Bilateral Hand Transplantation: Supporting the Patient's Choice. Journal of Plastic, Reconstructive & Aesthetic Surgery 2017;70(2):147-151.
Jowsey-Gregoire SG, Kumnig M, Morelon E, et al. The Chauvet 2014 Meeting Report: Psychiatric and Psychosocial Evaluation and Outcomes of Upper Extremity Grafted Patients. Transplantation 2016;100(7):1453-1459.
Smith CP. How should Surgeons Balance Transplantation Innovation with Acceptance of a Trauma Survivor’s Appearance? AMA Journal of Ethics. 2019;21(11):953-959.