Caution Urged on Hand Transplantation

Following a visit to patients who have hand transplants, a plastic surgeon urges caution in proceeding with such transplants, according to a position paper by the American Society for Surgery of the Hand (ASSH), of which he was the principal author.

W.P. Andrew Lee, M.D., professor of surgery and chief of plastic surgery at the University of Pittsburgh Medical Center (PA, USA), visited and examined 11 of the 14 patients who have had confirmed hand transplants since 1998. He says that much more work needs to be done in understanding tissue rejection and minimizing anti-rejection drugs before hand transplantation should be performed on a widespread basis. Successful hand transplant patients have required continuous and heavy immunosuppression therapy, which carries significant risks.

"Many surgeons currently don't believe the risk of long-term immunosuppression is worthwhile because of its significant side-effects for a procedure that does not save a patient's life,” said Dr. Lee. "But there is no question there can be benefits in selected patients and I think that while hand transplantation holds great promise for the future, more laboratory research needs to be done.”

The report states, "At this time, the ASSH continues to urge great caution and a measured approach to the patient requesting a limb transplant. We encourage all surgeons to await the outcomes of the current human experimental studies before additional combined trials are considered. The public, especially those with traumatic loss of limb, must be carefully counseled and advised regarding the substantial risks to limb and life associated with these procedures to date.”



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