The current state of hand transplantation.

Hand transplantation is the most common form of modern composite tissue allotransplantation. Successful application of this technology requires a multidisciplinary approach incorporating not only skilled hand surgeons, transplant surgeons, and transplant immunologists, but also hand therapists, psychiatrists, medical specialists, anesthesiologists, and others. Functional outcomes can be life changing for properly selected candidates. Hand transplantation is becoming more common, with more centers offering this relatively new reconstructive modality. Its success depends on proper patient selection, a technically successful operation, postoperative rehabilitation, and an immunotherapy protocol that prevents rejection but has minimal or acceptable morbidity.