Follow-Up Report on Hand Transplantation

A follow-up on a transplant performed in January 1999 has shown that early success in hand transplantation can be achieved with the use of current immunosuppressive drugs. The operation, the first hand transplant to be performed in the United States, took place at the Jewish Hospital of Louisville (KY, USA), following a successful hand transplant performed in France only four months earlier. A report and update on the U.S. transplant was published in The New England Journal of Medicine (2000;343:468-473).

The team of doctors who performed the operation report that the patient's skin, wound, and bone healing were normal following the operation, and nerve regeneration more rapid than expected. However, the patient experienced three episodes of acute cellular rejection, at six, 20, and 27 weeks. These were successfully treated with intravenous methylprednisolone, topical tacrolimus, and clobetasol, a protocol relying mainly on the team's studies of rejection treatment in pigs.

Less than four months after the transplantation, the patient returned to work. At one year, pain, pressure, and temperature had developed in the patient's hand and fingers. By then, the patient was able to perform many functions with his new hand that had been impossible with his prosthesis. These included tying his shoelaces and throwing a baseball. The doctors report that the patient is psychologically well adjusted and has incorporated the graft into his self-image.