Reconstructive surgery, Clínica Cavadas, Valencia, Spain.
Am J Transplant. 2011 May;11(5):1085-90. doi: 10.1111/j.1600-6143.2011.03503.x.
Unilateral and bilateral hand transplantations have been performed worldwide with good mid-term functional results. An above-elbow bilateral transplantation was performed in a 29-year-old male patient from a fully HLA-mismatched donor. Alemtuzumab induction and steroid-free maintenance immunosuppression with tacrolimus and mycophenolate was used. Due to acute rejection, steroids were introduced at 6 months. Three acute rejection episodes occurred, one treated with alemtuzumab. New-onset diabetes after transplant, dyslipemia and worsening of previous high blood pressure required treatment. At 26 months post-transplantation, the patient has excellent elbow active movement, active flexion and extension of the thumb and fingers, useful sensation and a gainful job. Based on the functional results of the case reported, bilateral trans-humeral transplantation could be a viable treatment for selected bilateral above-elbow amputees.
全球范围内已经进行了单侧和双侧手部移植，取得了良好的中期功能结果。一名 29 岁的男性患者从完全 HLA 错配的供体中接受了肘上双侧移植。使用了阿仑单抗诱导和无类固醇的维持免疫抑制治疗，包括他克莫司和霉酚酸酯。由于急性排斥反应，在 6 个月时引入了类固醇。发生了 3 次急性排斥反应，其中 1 次用阿仑单抗治疗。移植后新发糖尿病、血脂异常和先前高血压恶化需要治疗。移植后 26 个月，患者肘部主动运动、拇指和手指主动屈伸、感觉良好，并且能够工作。基于所报告病例的功能结果，对于选择的双侧肘上截肢患者，双肱骨移植可能是一种可行的治疗方法。
