FAQ´s (for patients)
How Many Hand and Upper Limb Transplants Have Been Performed?
To date, 72 upper limb and hand transplants have been performed. Twenty-one of these have been bilateral, 30 have been unilateraltransplants.
Excluding those performed in China, for whomimmunosuppression is not guaranteed, failures have been few.
Seven of eight transplants have survived to ten years. One limb was removed at the patient’s request but was otherwise functional.
Eighteen transplants have now survived past 5 years.
One limb has been lost at 45 days as a result of infection, and a second lost as a result of reduced blood flow.
One patient, who received a combined face and double upper limb transplant died as a result two months following surgery due to a complication of the face transplantation.
What Function Can I expect From A Transplanted Hand?
So far good outcomes have been experienced in most transplanted limbs.
You can expect the limb to be feel touch, perform fine and course movement, be warm when touched and heal when injured. Some functions return quicker than others and complete function may take several years to develop. Individual outcomes can vary and depend on many factors – some of which are under our control, and some of which are not.
How Do The Outcomes Of Transplantation Compare To Prostheses?
In comparison to a prosthetic, a reattached limb achieves a good or excellent outcome in 50% of cases whereas 100% of prostheses achieve only fair or poor outcomes as measured by standardised tests.
Data is however limited and all transplants vary.
Will I know who the donor is?
No. All patients have a right to a confidentiality of their medical record. This includes deceased donors and their families. Hence, those receiving a transplant will not ordinarily know the identity of the donor or their family. Should a transplant recipient wish to contact the family of their donor then this can be arranged through NHS Blood and Transplant.
Will I Get A Say As To Which Limb I Receive?
Yes. You will be asked to specify the characteristics of a limb that you feel would be suitable for you. You must make this decision at the time of entry to the programme, not at the time of offer of transplant. You will not be able to see the donor limb prior to transplant but it will match the criteria that you specified.
What Characteristics Can I Specify? Will Limbs Be Matched For Size, Age, Gender and Skin Colour?
You will be asked to specify the range of skin tones and limb sizes that you would consider acceptable. You may also choose to accept or reject limbs of the opposite sex and to specify an age range of the donor organ.
This selection process occurs at entry to the programme and organs will be identified and offered based upon the conditions you specify. Once a suitable donor match is identified, an offer of transplantation will be made. At this time, you will be able to accept or reject the offer but will not be able to view the donor or their limb.
You should give thought to how close a match you want the donated limb to match your own. A perfect match may look best but may be difficult to find. We don’t know how many people will choose to donate their limbs.
It is important to note that limbs may change size, shape and colour following transplantation.
How Will I Be Followed Up?
The surgery, postoperative care and initial rehabilitation will be performed at Leeds General Infirmary. It is expected that you will return to your own home upon discharge.
Comprehensive follow up is required and Leeds will remain the coordinating centre following discharge. You will be expected to return to Leeds for regular drug monitoring and medical follow up.
Rehabilitation is an extremely important part of your recovery and you will need to work very hard initially to make sure that your new hand(s) function as you would want them to. Occupational and physical therapy will start straight after surgery whilst you are an inpatient.
After you leave hospital therapy can either continue in Leeds or at your local hand or plastic surgery department depending upon the availability of skills and services. You would still however, require frequent trips back to Leeds for monitoring and follow up.
Should any concerns or complications arise after surgery, the Leeds transplant team should immediately be notified. Any treatment of such complications should be conducted at Leeds General Infirmary.