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article

Innovations in reconstructive microsurgery: Reconstructive transplantation

Branislav Kollar, Sotirios Tasigiorgos, Miguel I. Dorante, Matthew J. Carty, more

Journal of Surgical Oncology > 118 > 5 > 800 - 806

In the past 20 years, reconstructive transplantation (RT) has emerged as a viable reconstructive option for carefully selected patients. More than 100 upper extremity and 40 face transplants have been performed worldwide to date. Concomitantly, the portfolio of reconstructive transplantation has been extended by additional procedures such as lower extremities, abdominal wall, neck, uterus, genitourinary,...

article

Ex-vivo flush of the limb allograft reduces inflammatory burden prior to transplantation

Kavit R. Amin, Alexandra L. Ball, Chandanpreet Chhina, Rebecca J. Edge, more

Journal of Plastic, Reconstructive & Aesthetic Surgery > 2018 > 71 > 2 > 140-146

Passenger leucocytes and inflammatory debris transferred from the donor limb to the recipient can induce allorecognition, which activates the host immune response. This is the first study to evaluate whether the transfer of this inflammatory burden can be reduced via post-preservation flush prior to revascularisation, and whether this is influenced by ischaemia.Bilateral forelimbs from the same pig...

article

Oczekiwania i motywacja transplantacyjna potencjalnych biorców kończyny górnej – teoretyczno-badawcze studium socjologii fenomenologicznej

Katarzyna Kowal

Acta Universitatis Lodziensis. Folia Sociologica > 2016 > 59 > 123-150

Problematyka artykułu ulokowana jest na pograniczu socjologii i medycyny. Jego celem jest przedstawienie oczekiwań i motywów chorych okaleczonych deficytem ręki, które związane są z ich potencjalnym udziałem w zabiegu transplantacji kończyny. Kontekstem ich poznania ustanowiono sprawnościowe i wizualne doświadczanie w przeszłości ciała sfragmentaryzowanego oraz sprawnościowe i wizualne doświadczanie...

article

The Utility of Hand Transplantation in Hand Amputee Patients

Noor Alolabi, Jennifer Chuback, Sharon Grad, Achilles Thoma

Journal of Hand Surgery > 2015 > 40 > 1 > 8-14

To measure the desirable health outcome, termed utility, and the expected quality-adjusted life years (QALYs) gained with hand composite tissue allotransplantation (CTA) using hand amputee patients and the general public.Using the standard gamble (SG) and time trade-off (TTO) techniques, utilities were obtained from 30 general public participants and 12 amputee patients. The health utility and net...

article

Vascularized composite allotransplantation: An update on medical and surgical progress and remaining challenges

Blake D. Murphy, Ronald M. Zuker, Gregory H. Borschel

Journal of Plastic, Reconstructive & Aesthetic Surgery > 2013 > 66 > 11 > 1449-1455

In vascularized composite allotransplantation, multiple types of tissue are transferred from donor to recipient as a single functional unit. This technique has been performed for upper extremity, face, and abdominal wall transplants, among many others.To review the existing cases of face and upper extremity vascularized composite allotransplantation performed to date and to describe the functional...

article

Doświadczanie własnej cielesności przez biorców kończyny – socjologiczne stadium zrekonstruowanego ciała

Katarzyna Kowal

Przegląd Socjologii Jakościowej > 2012 > 8 > 2 > 152-199

The paper is devoted to the problem of upper limb recipients’ experience of their own corporeality during the period before and after the transplantation. The research sample consisted of upper limb transplant recipients, the choice of whom was purposive and determined by the criterion of time which had passed since the transplantation. The subjects of the research were 3 men aged 30-38 who had lost...

article

Educational Objectives

Jaimie T. Shores, Joseph E. Imbriglia, W.P. Andrew Lee

Journal of Hand Surgery > 2011 > 36 > 11 > 1862-1867

Hand transplantation is the most common form of modern composite tissue allotransplantation. Successful application of this technology requires a multidisciplinary approach incorporating not only skilled hand surgeons, transplant surgeons, and transplant immunologists, but also hand therapists, psychiatrists, medical specialists, anesthesiologists, and others. Functional outcomes can be life changing...

article

Risk assessment and management in hand and facial tissue transplantation

J. H. Barker, F. Allen, M. Cunningham, P. S. Basappa, more

European Journal of Trauma and Emergency Surgery > 2011 > 37 > 5 > 469-476

Purpose Since hand and facial tissue transplantation are new treatments, risk data must be derived from early reports of the few cases done to date combined with extrapolations from other procedures with similar risks. This manuscript summarizes data from both sources including eight separate studies that measure the real and perceived risks associated with hand and facial tissue transplantation....

article

Allograft vasculopathy after allogeneic vascularized knee transplantation

Michael Diefenbeck, Andreas Nerlich, Stefan Schneeberger, Frithjof Wagner, more

Transplant International > 24 > 1 > e1 - e5

Composite tissue allotransplantation represents a new discipline in reconstructive surgery. Over the past 10 years, we have performed six human vascularized allogeneic knee transplantations. All of these grafts have been lost within the first 56 months. A histomorphologic assessment of the latest case resulted in the detection of diffuse concentric fibrous intimal thickening and occlusion of graft...

article

Composite Tissue Vasculopathy and Degeneration Following Multiple Episodes of Acute Rejection in Reconstructive Transplantation

J. V. Unadkat, S. Schneeberger, E. H. Horibe, C. Goldbach, more

American Journal of Transplantation > 10 > 2 > 251 - 261

Transplant vasculopathy has not been systematically investigated in composite tissue allotransplantation (CTA). The impact of multiple acute rejections (ARs) on long‐term graft outcomes in reconstructive transplantation remains unknown. This study in a rat hind‐limb allotransplantation model systematically analyzes vasculopathy and tissue‐specific pathological changes secondary to multiple AR episodes. LEW rats were transplanted with BN rat hind limbs and treated as follows: Group 1 (Iso): isografts. Group 2 (CsA): Cyclosporine (CsA) qd; Group 3 (mult AR): CsA and dexamethasone only when AR was observed. No AR was observed in Groups 1 and 2. Multiple AR were observed in Group 3, and each episode was completely reversed (clinically) with pulsed CsA + dexamethasone treatment. Group 3 animals demonstrated significant vascular lesions along with skin and muscle atrophy, upregulation of profibrotic gene expression and fibrosis when compared to Groups 1 and 2. In addition, allograft bone was sclerotic, weak and prone to malunion and nonunion. Interestingly, vasculopathy was a late finding, whereas muscle atrophy with macrophage infiltration was seen early, after only a few AR episodes. Taken together, multiple AR episodes lead to vasculopathy and tissue‐specific pathology in CTA. This is the first evidence of ‘composite tissue vasculopathy and degeneration (CTVD)’ in CTA....

article

Composite tissue allotransplantation: a review of relevant immunological issues for plastic surgeons

Iain S. Whitaker, Eileen M. Duggan, Rita R. Alloway, Charlie Brown, more

Journal of Plastic, Reconstructive & Aesthetic Surgery > 2008 > 61 > 5 > 481-492

Composite tissue allotransplantation of hand, facial and other tissues is now a clinical reality. The terminology, treatment principles, drug combinations, dosage schedules and mechanisms of the immunosuppression medications on which contemporary transplant surgery is based are unfamiliar to plastic surgeons and most healthcare providers outside the field of transplantation medicine. With this in...

article

First Polish Hand Allograft - 6-Month Report

Jerzy Jabłecki, Leszek Kaczmarzyk, Dariusz Patrzałek, Adam Domanasiewicz, more

Comparative Professional Pedagogy > 2007 > 79 > 3 > 232-238

The transplant recipient is a 32 year-old man who lost his right, dominant upper limb on the level of the midpoint of his forearm in an accident 14 years ago. After a comprehensive pretransplantation evaluation and informed consent process he received a transplant of the right forearm, matched for size and skin tone, of a brain-dead man aged 47. The donor's limb was amputated at the elbow and irrigated...

article

First Polish Hand Allograft - 6-Month Report

Jerzy Jabłecki, Leszek Kaczmarzyk, Dariusz Patrzałek, Adam Domanasiewicz, more

Polish Journal of Surgery > 2007 > 79 > 3 > 232-238

article

Investigation of Risk Acceptance in Hand Transplantation

Ramsey K. Majzoub, Michael Cunningham, Federico Grossi, Claudio Maldonado, more

Journal of Hand Surgery > 2006 > 31 > 2 > 295-302

Twenty-four hands have been transplanted in 18 individuals and clinicians continue to debate whether the risks justify the benefits in these procedures. To assess quantitatively the risks versus benefits in hand transplantation we used a validated instrument (Louisville Instrument for Transplantation) to measure the degree of risk individuals are willing to accept to receive different types of transplantation...

article

Oczekiwania i motywacja transplantacyjna potencjalnych biorców kończyny górnej – teoretyczno-badawcze studium socjologii fenomenologicznej

Wydawnictwo Uniwersytetu Łódzkiego, Katarzyna Kowal, Wydział Filologiczno-Historyczny Akademia im. Jana Długosza w Częstochowie, k.kowal@ajd.czest.pl

Acta Universitatis Lodziensis. Folia Sociologica > Acta Universitatis Lodziensis. Folia Sociologica 2016, nr 59

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