A team of researchers from Emory University, Atlanta, Georgia, and the Veterans Administration (VA) is now recruiting people with transradial amputations to receive hand transplants.
Linda Cendales, MD, is the principal investigator in the study and is assistant professor of surgery and director of composite tissue transplantation and the laboratory of microsurgery at the Emory Transplant Center. “Any [transradial] amputee 18 to 55 years old is welcome to give us a call,” Cendales said. “They can be either from the VA system or from the general population…and this protocol includes amputees no matter how long the amputation has been there-six months, one year, 30 years, or 40 years. I would be happy to give them some information, answer any questions they have, and to start an evaluation.”
Cendales called hand transplantation, “an option, certainly not for all amputees, but an option for a select group of amputees who may not be benefiting from a prosthesis, or for whom a prosthesis is not a good choice.”
Thirty-three people worldwide have undergone hand transplantation, and of those whose surgery was performed in the western world, all but the first one have had successful outcomes. Cendales was on the team that performed the first two hand transplants in the United States, both of which remain a success. The only failed transplant in the western world was due to the patient’s discontinuation of anti-rejection drugs, which a transplant recipient must remain on for life. Cendales called the immunosuppressors a “lifetime commitment,” with many side effects, including the possibility of kidney damage. Steroids used in the drug regimen can cause diabetes, especially when used over the long term, but Cendales said the research team has a history of minimizing immunosuppression, has been able to reverse transplant rejection, and “at the Atlanta VA as well as at Emory, our protocol aims to avoid long-term steroids, which we hope will benefit our patient population.”
Once potential study participants have been fully evaluated, they will be placed on a waiting list for a donor hand or hands. Cendales said, “Right now, the limitation in transplantation in general is donor availability…. A difference between a hand and a kidney is that you don’t see a kidney. In addition to the blood type, for example, we need to add other parameters, such as the matching of the skin color, of the gender, and the size.”
Cendales called her research team “extraordinary,” partly because of its multidisciplinary approach. “We have research coordinators, social workers, researchers, physicians, rehabilitation specialists, and certainly an important component is the laboratory of prosthetics…. We’re all working together.” She concluded, “This is a very exciting time. Now we can offer our amputees another option for reconstruction, and our program at the VA and Emory is doing it in a systematic way…. We, meaning our team, have dedicated our lives to this, and now we’re able to offer our patients part of what we’ve worked for so many years.”
For more information, contact Linda Cendales, MD, 404.727.1731; e-mail: