Vögelin Esther
Klinik für Plastische und Handchirurgie und Chirurgie der peripheren Nerven, Inselspital, Bern.
Ther Umsch. 2011 Dec;68(12):730-4. doi: 10.1024/0040-5930/a000237.
Hand transplantation has been indicated in selective patients after traumatic upper extremity amputation and only performed in a few centers around the world for the last decade. In comparison to solid organ transplantation, there is a challenge to overcome the host immunological barrier due to complex antigenicity of the different included tissues, the skin being the most susceptible to rejection. Patients require lifelong immunosuppression for non life-threatening conditions. Minimization of maintenance immunosuppression represents the key step for promoting wider applicability of hand transplantation. Current research is working towards the understanding mechanisms of composite tissue allograft (CTA) rejection. Worldwide, in 51 patients 72 hands (21 double hand transplants) and once both arms have been successfully transplanted since 1998.
对于创伤性上肢截肢后的特定患者，已表明可进行手部移植，在过去十年中，全球仅有少数几个中心开展了此类手术。与实体器官移植相比，由于所包含的不同组织具有复杂的抗原性，尤其是皮肤最易发生排斥反应，因此要克服宿主免疫屏障面临挑战。对于非危及生命的情况，患者需要终身免疫抑制治疗。尽量减少维持性免疫抑制是促进手部移植更广泛应用的关键步骤。目前的研究致力于了解复合组织同种异体移植（CTA）排斥反应的机制。自1998年以来，全球共有51例患者接受了72只手（21例双手移植）的移植，还有1例双臂移植成功。
