Korean J Transplant.  2022 Nov;36(Supple 1):S148. 10.4285/ATW2022.F-2663.

Second hand allotransplantation experience after the revised transplantation law: 5-month follow-up

• Kim Y
• Hong JW
• Lee SJ
• Kim SH
• Jwa SJ
• Joo OY
• Mo YW
• Suh YC
• Choi YR
• Joo DJ

• KMID: 2535664
• DOI: http://doi.org/10.4285/ATW2022.F-2663

Abstract

Background
Hand transplantation for upper extremity amputation provides a unique treatment that restores form and function. In January 2021, the first hand allotransplantation since legalization was successfully performed. Based on that experience, the authors performed a second Hand allotransplantation in March 2022.
Methods
A-47-year-old man patient underwent mechanical amputation injury in February 2019. After going through the registra-tion process of waiting for transplant registration, hand transplantation was performed in March 2022. The transplantation was performed in distal 1/3 in right forearm. The Immunosuppressive induction therapy included basiliximab with successive mainte-nance therapy of tacrolimus, methylprednisolone and mycophenolate mofetil. And proper anti-coagulant therapy was performed before and after surgery.
Results
The operation took about 18 hours, and there was no abnormality in the blood flow of the transplanted hand after the operation. One month after the operation, a debridement and skin graft was performed on partial skin necrosis of forearm. A mild acute rejection episode was found (postoperative day 2 months), in which hand skin rash occurred. Rejection episode is resolved through steroid pulse therapy. The graft is tolerable with current maintain dose of lowered tacrolimus level and oral steroid. Dorsal, volar and finger area senses are currently being restored, and cognitive senses for each digit are also being restored. Motor function is also being trained through rehabilitation exercise.
Conclusions
The 47-year-old male patient's hand allotransplantation has been good so far, and it is necessary to thoroughly ob-serve whether there is a rejection reaction in the future and focus on rehabilitation treatment at the same time.