Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

21 May 2009

Limb transplantation, multiorgan transplantation

R Margreiter

Ann Transplant 2009; 14(1): 20-20 :: ID: 880270

Abstract

Up to 1st of April 2009 a total of 46 hand transplants have been performed
worldwide, 2 forearm transplants and 4 arm transplants. Of the hand transplants 22 were single and 11 double transplants. We have experience with three patients, two double hand transplants and one double forearm transplant. The first patient was transplanted in March 2000, the second patient (bilateral forearm) in February 2003 and the 3rd patient in May 2006. Total cold ischemia was between 150 and 211 minutes. HLA-match was 0 in patient 1, 2 in patient 2 and 3 in patient 3. Induction therapy consisted of ATG for 4 days in the first 2 patients and Campath-1H in the third patient. Maintenance immunosuppression comprised Tacrolimus, MMF and Prednisolone. In our longest survivor Tacrolimus was converted to Sirolimus after 4 years. Three rejection episodes were observed in the 1st patient, 6 in the second patient and 4 in the 3rd patient. Rejections were treated with pulsed steroids and steroid resistant rejections with ATG and in one patient an ATG resistant rejection was reversed with Campath-1H. At 9 years our first patient is on low dose Sirolimus plus MMF and the two other patients on a Tacrolimus based triple drug regimen. Functional results are good - excellent up to 9 years following transplantation. Currently, there is no sign of chronic rejection in any of the patients. Per definitionem multiorgan transplantation means transplanting at least 3 or more organs en-bloc and was pioneered by Th. Starzl who named it multivisceral transplantation. Up to 31st of March 2005 a total of 232 multivisceral transplants have been reported to the registry including, however, cases of intestine and stomach transplantation. We have performed our first case in 1989 in a 49-year old male, who became the first long-term survivor ever and 11 further cases thereafter. One year graft survival is close to 80% in patients transplanted in more recent years.

Keywords: Limb Transplantation, Immunosuppression

Add Comment 0 Comments

In Press

12 Feb 2024 : Original article  

No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Li...

Ann Transplant In Press; DOI: 10.12659/AOT.942767  

21 Feb 2024 : Original article  

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians

Ann Transplant In Press; DOI: 10.12659/AOT.943498  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358