FAQ's (for professionals)
Will My Patient Get A Say As To What Limb Is Offered?
Yes. The recipient will be asked to specify the characteristics of a limb that they consider suitable for transplantation. These decisions will however be made upon entry to the programme, not at the time of offer of transplant. The recipient will not have the opportunity to see and accept or reject a limb that is matched to their criteria at the time of organ offering.
Will Limbs Be Matched For Size, Age, Gender and Skin Colour?
Yes. Patients selected to enter the hand transplantation programme will be permitted to specify a range of skin tones and limb sizes that they consider acceptable in a potential donor limb. Recipients 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 parameters specified by the recipient. Once a suitable donor match is identified, an offer of transplantation will be made. The recipient is able to accept or reject the offer but will not be able to view the donor or their limb.
How Will My Patient Be Followed Up?
The surgery, postoperative care and initial rehabilitation will be performed at Leeds General Infirmary. It is expected that your patient will return to his or her own home upon discharge. We encourage, and would be grateful for your involvement in the planning of the surgery and welcome your attendance and participation in performing the transplant itself should you wish.
Comprehensive follow up plans are required and Leeds will remain the coordinating centre following discharge. Your patient will be expected to return to Leeds for regular drug monitoring and medical surveillance by the transplant team. Rehabilitation, occupational and physical therapy will commence prior to discharge and can continue at the Leeds Hand Clinic or within your department depending upon the patients’ wishes and the availability of local skills and services. It is our wish to share on-going care between Leeds and your unit or practice as far as is practical.
Patients are required however, to maintain regular contact with the Leeds transplant team. Should any concerns arise or complications be encountered (whether confirmed or suspected), the Leeds transplant team should immediately be notified. Any treatment of such complications should be conducted at Leeds General Infirmary.
Why Are Children Not Included?
Suitable donors for paediatric transplantation are likely to be few. Additionally, upper limb transplantation is a non-lifesaving, complex procedure; technically, medically and ethically. It therefore requires the transmission of a great deal of knowledge and the ability to balance complex risks and benefits. Imparting this information to those who are not physically or psychologically mature may expose the individual to undue risk.
Hand transplantation also remains in its infancy and the long-term effects may as yet be unknown. It is possible that the longer duration of immunosuppression required in children may lead to greater complications later in life, weakening the indications for transplantation.
Those with congenital deformity are not presently considered to be suitable candidates due to their unpredictable anatomy and variable nerve function.