The Nuances of Hand Transplantation after Sepsis.
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All Authors
Zuo, K.J.
Leonard D.A.
Shores J.T.
Talbot S.G.
LTHT Author
Leonard, David
LTHT Department
Plastic & Reconstructive Surgery
Hand Surgery
Hand Surgery
Non Medic
Publication Date
2024
Item Type
Article
Language
Subject
Subject Headings
Abstract
Vascularized composite allotransplantation (VCA) of the upper extremity is an established restorative procedure for selected patients with acquired upper limb loss. The majority of upper limb VCAs performed worldwide have been for victims of various forms of trauma. However, in the developed world, amputation following severe sepsis seems to be an increasingly common indication for referral to hand transplant programs. Unlike trauma patients with isolated limb injuries, patients with amputations as a complication of sepsis have survived through a state of global tissue hypoperfusion and multisystem organ failure with severe, enduring effects on the entire body's physiology. This article reviews the unique considerations for VCA candidacy in postsepsis patients with upper limb amputation. These insights may also be relevant to postsepsis patients undergoing other forms of transplantation or to VCA patients requiring additional future solid organ transplants.
Journal
Transplantation