Hand transplantation following amputation due to non-malignant indications

Nachemson A, Fredrikson P, Jivegård L, Persson J, Sassu P, Svanberg T, Sjögren P
Record ID 32018011364
English
Authors' objectives: Background: Bilateral upper extremity amputation is a devastating consequence of a traumatic or medical event that tremendously affects the life of a person both functionally and psychologically. Most daily life activities are severely impeded and personal assistance is required. The recommended treatment for upper limb amputees in Sweden is prosthetic replacement using either standard or osseointegrated prosthesis. No other treatment is thus far available for Swedish patients who cannot use a prosthesis. Hand transplantation is available in some countries (e.g. USA, France, Poland) and several health care centres consider it a valuable option particularly for bilateral amputees after a period of at least six months of failed attempt to use prostheses. Objective: To evaluate upper extremity transplantation in adults with hand/upper extremity amputation (non-malignant causes), for decision support for introduction of bilateral upper extremity transplantation in Region Västra Götaland.
Authors' results and conclusions: Upper extremity transplantation in adults with hand/upper extremity amputation (non-malignant causes) probably improves ADL, probably provides useful hand motor and sensory functions (moderate certainty of evidence, GRADE ⊕⊕⊕) and may improve HRQoL and ability to return to work (low certainty of evidence, GRADE ⊕⊕). Serious complications are common and need to be considered and thoroughly discussed with the patient before transplantation. Further and larger studies with long-term follow-up are needed.
Details
Project Status: Completed
Year Published: 2016
English language abstract: An English language summary is available
Publication Type: Full HTA
MeSH Terms
  • Hand Transplantation
  • Amputees
Contact
Organisation Name: The Regional Health Technology Assessment Centre
Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden
Contact Name: hta-centrum@vgregion.se
Contact Email: hta-centrum@vgregion.se
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