Center for Rehabilitation, Occupational Therapy, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA.
Phys Occup Ther Pediatr. 2022;42(6):663-679. doi: 10.1080/01942638.2022.2057210. Epub 2022 Apr 4.
Describe the 5-year outcomes of the first successful pediatric bilateral hand transplantation.
The child underwent quadrimembral amputation at age two and received bilateral hand allografts at age eight. Rehabilitation included biomechanical, neurorehabilitation, and occupational approaches in acute and outpatient settings. Therapist observed outcomes, patient-reported measures, and parent-reported measures were repeated over a 5-year period.
Observation assessments revealed functional dexterity skills and modified independence to full independence with self-care activities. The parent reported the child had moderate difficulty with upper extremity functioning 25-, 41-, and 48-months post-transplantation, and mild difficulty at 60-months; the child reported no difficulties in this domain at 41 months. Five years post-transplantation the child reported enjoying many age-appropriate activities, and high-quality peer relations were endorsed by both parent and child.
The child developed hand movements for daily activities and was completing daily activities with improved efficiency. Health-related quality of life outcomes were favorable.
描述首例成功的儿科双侧手移植后的 5 年结果。
患儿在 2 岁时接受了四肢截肢，在 8 岁时接受了双侧手同种异体移植。康复包括在急性期和门诊环境中采用生物力学、神经康复和职业方法。治疗师观察了 5 年期间的结果、患者报告的测量结果和家长报告的测量结果。
观察评估显示，患儿具有功能性灵巧技能，并从自我护理活动的完全依赖逐渐发展为独立。家长报告说，患儿在移植后 25、41 和 48 个月时上肢功能有中度困难，60 个月时有轻度困难；患儿在 41 个月时在这个领域没有困难。移植后 5 年，患儿报告说喜欢许多适合年龄的活动，并且高质量的同伴关系得到了患儿和家长的认可。
患儿手部运动功能逐渐发展，用于日常活动，且完成日常活动的效率有所提高。健康相关生活质量的结果是有利的。
