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Arm and Hand Transplant

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46 papers 0 to 25 followers Includes upper limb and hand vascularized composite allotransplantation
By Mafer Amber QxMD ambassador, Mexican med student currently in 4° year, doing clinical research in vascularized composite allotransplantation
https://www.readbyqxmd.com/read/27826601/plasma-micrornas-are-potential-biomarkers-of-acute-rejection-after-hindlimb-transplantation-in-rats
#1
Hiroki Oda, Ryosuke Ikeguchi, Hirofumi Yurie, Yukitoshi Kaizawa, Souichi Ohta, Koji Yamamoto, Tomoki Aoyama, Shuichi Matsuda
BACKGROUND: The development of effective immunosuppressive regimens has resulted in many cases of successful hand transplantation. Visual skin inspection and histological evaluation are used to assess the rejection of hand transplants, but these methods are largely subjective. In this study, we aimed to determine the potential of microRNAs (miRNAs) as biomarkers for acute rejection in vascularized composite allotransplants. METHODS: In allograft group, 7 male Brown-Norway rats (RT1(n)) were used as donors and 13 male Lewis rats (RT1(l)) were used as recipients...
November 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27740465/perioperative-management-of-a-bilateral-forearm-allograft
#2
M Clerc, J Prothet, T Rimmelé
Composite tissue allotransplantation (CTA) is a complex procedure requiring a multidisciplinary collaboration between surgeons, anesthetists, and transplantation specialists. We will describe the perioperative management of a bilateral forearm allograft performed at our facility. A 40-year-old man who lost both forearms was registered on the transplant waiting list; a suitable graft was available 11months later. Anesthesia required planning for vascular access, hemodynamic monitoring, fluid therapy management and prevention of deep vein thrombosis...
June 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27712754/metacarpal-like-and-metacarpal-hand
#3
Nidal Farhan ALDeek, Yu-Te Lin, Fu-Chan Wei
The metacarpal-like and metacarpal hand injuries are devastating conditions that render the hand nonfunctional. Although the metacarpal hand is well-studied, the metacarpal-like hand is never addressed. The authors, using the same principles as in the classification and treatment of metacarpal hand, propose an easy to follow treatment algorithm for metacarpal-like hand injury to guide the reconstructive surgeon. For both injuries, microsurgical toe-to-hand transplantation can restore an acceptable level of function if done properly...
November 2016: Hand Clinics
https://www.readbyqxmd.com/read/27681267/long-term-tolerance-towards-haploidentical-vascularized-composite-allograft-transplantation-in-a-canine-model-using-bone-marrow-or-mobilized-stem-cells
#4
Jeff Chang, Scott S Graves, Tiffany Butts-Miwongtum, George E Sale, Rainer Storb, David W Mathes
BACKGROUND: The development of safe and reliable protocols for the transplantation of the face and hands may be accomplished with animal modeling of transplantation of vascularized composite allografts (VCA). Previously, we demonstrated that tolerance to a VCA could be achieved after canine recipients were simultaneously given marrow from a dog leukocyte antigen (DLA) identical donor. In the present study, we extend those findings across a DLA mismatched barrier. METHODS: Eight Recipient dogs received total body irradiation (4...
September 27, 2016: Transplantation
https://www.readbyqxmd.com/read/27638100/technology-and-vascularized-composite-allotransplantation-vca-lessons-learned-from-the-first-bilateral-pediatric-hand-transplant
#5
REVIEW
Arash Momeni, Benjamin Chang, L Scott Levin
The reconstructive principle of replacing "like with like" is best met with vascularized composite allotransplantation in which the components of an existing defect are "matched" to the greatest extent possible in a single stage restoration. Hand transplantation is a labor-intensive and time-intensive process and can be conceptualized into distinct phases that include (1) patient selection and preoperative preparation, (2) technical execution of the procedure, and (3) postoperative rehabilitation and follow-up...
November 2016: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/27556621/a-porcine-orthotopic-forelimb-vascularized-composite-allotransplantation-model-technical-considerations-and-translational-implications
#6
C Anton Fries, Carole Y Villamaria, Jerry R Spencer, Rory F Rickard, Vijay S Gorantla, Michael R Davis
BACKGROUND: The restoration of complex tissue deficits with vascularized composite allotransplantation is a paradigm shift in reconstructive surgery. Clinical adoption of vascularized composite allotransplantation is limited by the need for systemic immunosuppression, with associated morbidity and mortality. Small-animal models lack the biological fidelity and preclinical relevance to enable translation of immunologic insights to humans. Large-animal models have been described; however, limitations persist, including the inability of heterotopic models to evaluate functional nerve regeneration, and the sensitivity of primates to toxicity of immunosuppressive drugs...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27624820/successful-recovery-and-transplantation-of-11-organs-including-face-bilateral-upper-extremities-and-thoracic-and-abdominal-organs-from-a-single-deceased-organ-donor
#7
Stefan G Tullius, Bohdan Pomahac, Heung Bae Kim, Matthew J Carty, Simon G Talbot, Helen M Nelson, Francis L Delmonico
We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor...
October 2016: Transplantation
https://www.readbyqxmd.com/read/27517505/donor-specific-antibodies-and-antibody-mediated-rejection-in-vascularized-composite-allotransplantation
#8
Annemarie Weissenbacher, Alexandre Loupy, Anil Chandraker, Stefan Schneeberger
PURPOSE OF REVIEW: The presence of donor-specific antibodies (DSA) increases the risk of graft failure. Although DSA characteristics, human leukocyte antigen class specificity, mean fluorescence intensity and immunoglobulin G subclasses, and their impact on the graft are quite well studied in solid organ transplants, very little information is known about their impact on vascularized composite allotransplantation (VCA). The aim of this review is to highlight recent publications regarding occurrence and effects of DSA, their follow-up and treatment in the field of VCA...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27517506/an-integrated-view-of-immune-monitoring-in-vascularized-composite-allotransplantation
#9
Antoine Sicard, Jean Kanitakis, Valérie Dubois, Palmina Petruzzo, Lionel Badet, Olivier Thaunat, Emmanuel Morelon
PURPOSE OF REVIEW: Vascularized composite allotransplantation (VCA) has several immunological peculiarities that imply a specific immune monitoring. Here, we provide an integrated view of current procedures of immune monitoring in VCA and potential complementary approaches learned from organ transplantation. RECENT FINDINGS: Because the skin is highly immunogenic and is the main target of the alloimmune response, immune monitoring in VCA essentially relies on visual inspection and pathological examination of for-causes and protocol skin biopsies...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27517503/standardizing-psychosocial-assessment-for-vascularized-composite-allotransplantation
#10
Sheila Jowsey-Gregoire, Martin Kumnig
PURPOSE OF REVIEW: Vascularized composite allotransplantation (VCA) encompasses hand, face, uterus, penile and lower extremity transplantation. Psychosocial factors are recognized as important, but no standard approach to the evaluation, selection or posttransplant care has been described and thus, the development of a standardized approach is needed. RECENT FINDINGS: Various psychosocial assessment tools have been reported. Body image and the functional impact of hand versus face transplantation are notable issues...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27500557/a-novel-rodent-orthotopic-forelimb-transplantation-model-that-allows-for-reliable-assessment-of-functional-recovery-resulting-from-nerve-regeneration
#11
B Kern, J D Budihardjo, S Mermulla, A Quan, C Cadmi, J Lopez, M Khusheim, S Xiang, J Park, G J Furtmüller, K A Sarhane, S Schneeberger, W P A Lee, A Hoke, S Tuffaha, G Brandacher
Improved nerve regeneration and functional outcomes would greatly enhance the utility of vascularized composite allotransplantation (VCA) such as hand and upper extremity transplantation. However, research aimed at achieving this goal has been limited by the lack of a functional VCA animal model. We have developed a novel rat mid-humeral forelimb transplant model that allows for the characterization of upper extremity functional recovery following transplantation. At the final end-point of 12 weeks, we found that animals with forelimb transplantation including median, ulnar, and radial nerve coaptation demonstrated significantly improved grip strength (1...
August 8, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27479834/extremity-war-injuries-x-return-to-health-and-function
#12
Col Jeffrey N Davila, Marc F Swiontkowski, Col Ret Romney C Andersen
The symposium Extremity War Injuries X: Return to Health and Function, presented by the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association, the Society of Military Orthopaedic Surgeons, and the Orthopaedic Research Society, was held in Washington, DC, on January 27 and 28, 2015. Course chairs Marc F. Swiontkowski, MD, and COL Jeffrey N. Davila, MD, presided over 2 days of general session lectures focusing on war/trauma-related musculoskeletal injuries resulting in service member disability, followed by small group discussions, with a goal of identifying knowledge gaps in the treatment of these injuries...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27495915/ischemia-reperfusion-injury-in-vascularized-tissue-allotransplantation-tissue-damage-and-clinical-relevance
#13
Franka Messner, Johanna Grahammer, Theresa Hautz, Gerald Brandacher, Stefan Schneeberger
PURPOSE OF REVIEW: Ischemia and reperfusion injury (IRI) in vascularized tissue allotransplantation (VCA) remain largely undefined. Because VCA is comprised of different tissues, the sensitivity towards IRI may not be uniform. We, herein, attempt to address mechanistic aspects of IRI in VCA and provide a summary on potential technologies and targets for amelioration or treatment of IRI in this novel field. RECENT FINDINGS: IRI results in a loosened architecture of musculature, hypertrophic, centrally located cell nuclei as well as a high degree of neovascularization...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27471833/recipient-derived-angiogenesis-with-short-term-immunosuppression-increases-bone-remodeling-in-bone-vascularized-composite-allotransplantation-a-pilot-study-in-a-swine-tibial-defect-model
#14
Dimitra Kotsougiani, Caroline A Hundepool, Liselotte F Bulstra, Patricia Friedrich, Alexander Y Shin, Allen T Bishop
Current vascularized composite allotransplantation (VCA) transplantation protocols rely upon life-long immune modulation to maintain tissue perfusion. Alternatively, bone-only VCA viability may be maintained in small animal models using surgical angiogenesis from implanted autogenous vessels to develop a neoangiogenic bone circulation that will not be rejected. This study tests the method's efficacy in a large animal model as a bridge to clinical practice, quantifying the remodeling and mechanical properties of porcine tibial VCAs...
July 29, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27468324/composite-tissue-transplant-of-hand-or-arm-a-health-technology-assessment
#15
(no author information available yet)
BACKGROUND: Injuries to arms and legs following severe trauma can result in the loss of large regions of tissue, disrupting healing and function and sometimes leading to amputation of the damaged limb. People experiencing amputations of the hand or arm could potentially benefit from composite tissue transplant, which is being performed in some countries. Currently, there are no composite tissue transplant programs in Canada. METHODS: We conducted a systematic review of the literature, with no restriction on study design, examining the effectiveness and cost-effectiveness of hand and arm transplant...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27399142/neo-digit-functional-reconstruction-of-mutilating-hand-injury-using-transplantation-of-multiple-composite-tissue-flaps
#16
Xiucun Li, Jianli Cui, Suraj Maharjan, Xin Yu, Laijin Lu, Xu Gong
PURPOSE: Functional reconstruction of mutilating hand injuries poses a challenge to the surgeon. We present our experience with use of multiple composite tissue flaps transplant for functional reconstruction of hand in patients with mutilating hand injuries. The associated merits and demerits of these surgical approaches are briefly discussed. METHODS: From August 2004 to October 2014, functional reconstruction of hand with transplantation of multiple composite tissue flaps was performed in 8 patients...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26824440/regulatory-aspects-of-vca-in-eurotransplant
#17
REVIEW
Undine Samuel
Vascularized composite allografts (VCAs) are a growing field within the area of transplantation. In 2014, the birth of a healthy baby after a successful uterus transplant from a living donor was reported in Sweden. VCAs are not specifically mentioned in any of the transplant acts of the Eurotransplant (ET) member states, which all belong to the European Union (EU). The Competent Authorities (CA) of the EU decided in 2012 that VCAs are to be regarded as organs. At the moment, there are no general guidelines in the ET area concerning wait list registration, allocation, procurement and transplantation, and also no regulations concerning reimbursement...
June 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/26924305/immunobiology-in-vca
#18
REVIEW
Christina L Kaufman, Michael R Marvin, Paula M Chilton, James B Hoying, Stuart K Williams, Huey Tien, Tuna Ozyurekoglu, Rosemary Ouseph
Transplantation of vascularized composite tissue is a relatively new field that is an amalgamation of experience in solid organ transplantation and reconstructive plastic and orthopedic surgery. What is novel about the immunobiology of VCA is the addition of tissues with unique immunologic characteristics such as skin and vascularized bone, and the nature of VCA grafts, with direct exposure to the environment, and external forces of trauma. VCAs are distinguished from solid organ transplants by the requirement of rigorous physical therapy for optimal outcomes and the fact that these procedures are not lifesaving in most cases...
June 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/26927941/vascularized-composite-allograft-specific-characteristics-of-immune-responses
#19
REVIEW
Fadi Issa
Vascularized composite allograft (VCA) transplantation, or reconstructive transplantation, has revolutionized the treatment of complex tissue and functional defects. Despite arriving during an age in which the immunology of solid organ transplant rejection has been investigated in much detail, these transplants have offered new perspectives from which to explore the immunobiology of transplantation. VCAs have a number of unique molecular, cellular, and architectural features which alter the character and intensity of the rejection response...
June 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27295969/vascular-composite-tissue-transplantation-achievements-and-challenges-in-a-rapidly-developing-field
#20
EDITORIAL
Stefan G Tullius
No abstract text is available yet for this article.
June 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
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