Bilateral trans-humeral arm transplantation: result at 2 years

Am J Transplant. 2011 May;11(5):1085-90. doi: 10.1111/j.1600-6143.2011.03503.x.

Abstract

Unilateral and bilateral hand transplantations have been performed worldwide with good mid-term functional results. An above-elbow bilateral transplantation was performed in a 29-year-old male patient from a fully HLA-mismatched donor. Alemtuzumab induction and steroid-free maintenance immunosuppression with tacrolimus and mycophenolate was used. Due to acute rejection, steroids were introduced at 6 months. Three acute rejection episodes occurred, one treated with alemtuzumab. New-onset diabetes after transplant, dyslipemia and worsening of previous high blood pressure required treatment. At 26 months post-transplantation, the patient has excellent elbow active movement, active flexion and extension of the thumb and fingers, useful sensation and a gainful job. Based on the functional results of the case reported, bilateral trans-humeral transplantation could be a viable treatment for selected bilateral above-elbow amputees.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alemtuzumab
  • Amputation
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / pharmacology
  • Arm / transplantation*
  • Diabetes Complications / diagnosis
  • HLA Antigens / immunology
  • Hand Transplantation*
  • Humans
  • Hypertension / complications
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / pharmacology
  • Steroids / chemistry
  • Tacrolimus / pharmacology
  • Transplantation / methods*
  • Transplantation, Homologous / methods*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • HLA Antigens
  • Immunosuppressive Agents
  • Steroids
  • Alemtuzumab
  • Mycophenolic Acid
  • Tacrolimus