Psychosocial considerations in the assessment of hand transplant candidates: A single-center experience and brief literature review

Clin Transplant. 2021 Apr;35(4):e14268. doi: 10.1111/ctr.14268. Epub 2021 Mar 17.

Abstract

Vascularized composite allograft, including hand transplantation (HT), has gained wider usage as a reconstructive treatment over the past 30 years. HT recipients face unique psychosocial challenges compared to their solid organ and/or bone marrow transplant counterparts. Accordingly, the psychosocial evaluation among HT candidates continues to evolve, leaving a lack of consensus as to the critical psychosocial domains and psychometric testing instruments to help evaluate individuals considering HT. The present manuscript describes the psychosocial evaluation process within the Duke HT program, which been contacted by 80 potential candidates since 2014. The Duke HT evaluation process incorporates a comprehensive psychosocial assessment within domains including personality, cognitive function, mood, behavioral adherence, social support, and substance use history, among others. Our experience underscores the potential utility of collecting thorough psychosocial evaluations, supplemented by psychometric test data, to comprehensively assess potential HT candidates.

Keywords: depression; quality of life; vascular composite allograft.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Bone Marrow Transplantation
  • Hand Transplantation*
  • Heart Transplantation*
  • Humans
  • Social Support
  • Substance-Related Disorders*