Outcomes


Outcomes will depend greatly on individual circumstances and hence this website cannot be seen as a replacement to thorough discussion with members of the Hand Transplant Team.

Excluding transplants performed in the Orient, where immunosuppression is not guaranteed, great success has been observed.

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 intractable infection, and a second lost as a result of diffuse myointimal hyperplasia.

One patient, in receipt of a combined face and double upper limb transplant died as a result of airway obstruction on day 65.

In comparison to a prosthetic, a replanted limb achieves a good or excellent outcome in 50% of cases whereas 100% of prostheses achieve only fair or poor outcomes as measured by the Carroll test. Functional outcomes following hand transplantation are excellent, often exceeding outcomes observed following replantation.

Motor recovery begins with extrinsic muscle function. Intrinsic musculature shows evidence of activity by 9 to 15 months. Sensibility returns to the limb by 12 months. Protective sensation recovers in all cases, with 70% developing discriminative touch.

Better outcomes are associated with younger patients and distal injuries.