Yonsei Med J.
2024 Feb;65(2):108-119. 10.3349/ymj.2023.0365.
Reaching New Heights: A Comprehensive Study of Hand Transplantations in Korea after Institutionalization of Hand Transplantation Law
- Kim YH
1,2 - Choi YR3,4
- Joo DJ4,5,6
- Baek WY1,2
- Suh YC1,2
- Oh WT3
- Cho JY3
- Lee SC7
- Kim SK8
- Ryu HJ8
- Jeon KO4
- Lee WJ1,2
- Hong JW1,2,4
- Affiliations
-
- 1Departments of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
- 2Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
- 3Departments of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
- 4Organ Transplantation Center, Severance Hospital, Seoul, Korea.
- 5Departments of Surgery, Yonsei University College of Medicine, Seoul, Korea.
- 6The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.
- 7Departments of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 8Departments of Diagnostic Pathology, Yonsei University College of Medicine, Seoul, Korea.
- KMID: 2551171
- DOI: http://doi.org/10.3349/ymj.2023.0365
Abstract
- Purpose
With the revision of the Organ and Transplantation Act in 2018, the hand has become legal as an area of transplantable organs in Korea. In January 2021, the first hand allotransplantation since legalization was successfully performed, and we have performed a total of three successful hand transplantation since then. By comparing and incorporating our experiences, this study aimed to provide a comprehensive reconstructive solution for hand amputation in Korea.
Materials and Methods
Recipients were selected through a structured preoperative evaluation, and hand transplantations were performed at the distal forearm level. Postoperatively, patients were treated with three-drug immunosuppressive regimen, and functional outcomes were monitored.
Results
The hand transplantations were performed without intraoperative complications. All patients had partial skin necrosis and underwent additional surgical procedures in 2 months after transplantation. After additional operations, no further severe complications were observed. Also, patients developed acute rejection within 3 months of surgery, but all resolved within 2 weeks after steroid pulse therapy. Motor and sensory function improved dramatically, and patients were very satisfied with the appearance and function of their transplanted hands.
Conclusion
Hand transplantation is a viable reconstructive option, and patients have shown positive functional and psychological outcomes. Although this study has limitations, such as the small number of patients and short follow-up period, we should focus on continued recovery of hand function, and be careful not to develop side effects from immunosuppressive drugs. Through the present study, we will continue to strive for a bright future regarding hand transplantation in Korea.
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