Removing the Hand — Within Reach
Hand/Arm Transplant Definition Status History Worldwide Performance Functional Outcomes Psychological Outcomes Patient Experiences Potential Benefits Limitations Unknowns Myths and Facts
Process Transplant Evaluation Process Who is Eligible Who Makes a Good Candidate Contacting a Transplant Center Meeting the Transplant Team After Evaluation What is Surgery Like
Risks Surgical and Medical Acute and Chronic Rejection Removing the Hand Anti-Rejection Medicine Pain and Discomfort Emotional and Social
Recovery Surgical Recovery Rehabilitation Process Lifestyle Changes Caregiver's Role
Decision-Making Optional Treatment Weigh All Options Mental Health Changes Social Support Commitments Financial Costs
Options Cosmetic Prostheses Body-Powered Prostheses Electric Prostheses Myoelectric Prostheses Switch and Pressure Sensors LUKE Arm Osseointegration No Prosthesis
Resources 1 Glossary Hospital Finder Question Prompt Sheet Pamphlet Video Library Websites/Support Groups Study Findings
About Us Team Partners

Home > Risks > Removing the Hand

Removing the Hand

 

Dr. Dumanian, Chief of Plastic Surgery, talks about why some people with limb loss do not want to take the risk of re-amputation.

Angie Duckworth, Transplant Social Worker, talks about the risk of re-amputation.

 
 

Can the Hand/Arm Transplant Be Removed?

In some cases, the hand/arm transplant may need to be removed (“explantation”) if the transplant recipient experiences serious side effects or health complications.1-3

Reasons Recipients Had Their Hand/Arm Transplant Removed:

There are several reasons why recipients have had their hand/arm transplant removed.3-10

  • Unreported/ongoing rejection episodes
  • Infection
  • Blood clot
  • Intimal hyperplasia: this is the thickening of part of the blood vessel in response to injury
  • Sepsis and necrosis
  • Patients not taking their anti-rejection medicines as prescribed
  • Poor function of the hand/arm transplant
  • Patient’s decision

Risks and Benefits of Hand/Arm Transplant Removal (“Explantation”):

It is important to consider the risks and benefits of removing the hand/arm transplant.

  • Risks of removal include:
    • Complications during surgery
    • Additional recovery time after hand removal
    • Loss of residual limb length. If a hand/arm transplant needs to be removed, then the recipient will end up with a slightly shorter amputation stump than before the transplant. This happens because of technical reasons that relate to wound closure.
    • Decrease in functionality as compared to pre-transplant surgery functionality
    • Difficulty fitting a new prosthetic, or the need to have a new prosthetic because the residual limb will be a different shape or size than it was pre-transplant
    • Unlikely that recipient will be able to receive another hand/arm transplant
  • Benefits of removal include:
    • Ending anti-rejection medicine regimen and preventing potential side effects from the medicines1
 

Mr. Pollock, a bilateral, upper limb transplant recipient (11 ½ years after transplantation), talks about the importance of meeting with one’s doctors and listening to what they say.

 
 

References