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Surgical and Medical Risks

Dr. Jaimie Shores, Hand/Arm Transplant Surgeon, talks about risks during hand/arm transplant surgery.

Dr. Dumanian, Chief of Plastic Surgery, talks about the drawbacks and risks of hand/arm transplantation.

Dr. Jaimie Shores, Hand/Arm Transplant Surgeon, talks about follow-up surgeries or procedures that some patients may need after they receive their hand/arm transplant.

 

The surgical risks of hand/arm transplantation are similar to the risks of other surgical procedures or transplant surgeries (e.g., kidney or liver transplant), including:

Risk of Death from Anesthesia

  • The risk of death related to anesthesia and surgery is low.
  • Since 1998, when hand/arm transplants first began, only one death occurred, which was a patient in Mexico who died immediately after bilateral hand transplantation. 1
  • Hand/arm transplantation poses more risks after surgery than during surgery.

Risk of Infection

  • As with other surgical procedures, there is risk for infection of the surgical wound.
  • Sepsis can happen when an infection you have triggers a chain reaction throughout your body. The body’s reaction to the infection damages its own tissues. 2,3

Risk of Scarring

 

Dr. Dumanian, Chief of Plastic Surgery, describes the potential for scarring from the hand/arm transplant procedure.

 

Risk of Getting Chronic Diseases (conditions that last 1 year or more and require ongoing medical attention), including:

  • Diabetes4
  • High blood pressure (hypertension)5
  • Decreased bone density, increasing the likelihood to get bone fractures6
  • Kidney disease7

Risk That the Transplant(s) Will Be Unsuccessful and Will Need to Be Removed.

 

References

Sources

  1. Shores JT, Brandacher G, Lee WPA. Hand and Upper Extremity Transplantation: An Update of Outcomes in the Worldwide Experience. Plast Reconstr Surg 2015;135(2):351e-360e.  

  2. What is sepsis? Centers for Disease Control and Prevention. Accessed August 9, 2022. https://www.cdc.gov/sepsis/what-is-sepsis.html.

  3. MacKay BJ, Nacke E, Posner M. Hand Transplantation--a review. Bulletin of the Hospital for Joint Diseases 2014; 72(1):76-88.  

  4. Giannis D, Moris D, Cendales LC. Costimulation Blockade in Vascularized Composite Allotransplantation. Front Immunol 2020 Sep;11:544186.

  5. Landin L, Bonastre J, Casado-Sanchez C, et al. Outcomes with Respect to Disabilities of the Upper Limb after Hand Allograft Transplantation: A Systematic Review. Transplant International 2012;25(4):424-432.

  6. Howe EG. Ethical Issues Posed by Face Transplants. The Journal of Clinical Ethics, 2019.

  7. Health Quality Ontario. Composite Tissue Transplant of Hand or Arm: A Health Technology Assessment. Ont Health Technol Assess Ser 2016 June;16(13):1-70.