NEW ORLEANS — Diane J. Atkins, OTR, FISPO, provided insight into the growing field of hand transplantation as an alternative for patients who have rejected upper limb prostheses during a presentation at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium, here.
Diane J. Atkins
Atkins, who specializes in upper limb rehabilitation, has worked with the hand transplant patient population for about 2 years. The first hand transplant was performed in 1998, and Atkins said 110 hand transplants have been performed on 73 patients since 2000. The majority of hand transplants have taken place in Austria, France, Turkey, Spain, Poland and Germy – but now the United States is catching up, she said.
“In the United States, it is definitely starting to grow,” Atkins said, citing the University of Kentucky and Louisville and Johns Hopkins University as the two U.S. sites on the cutting edge of hand transplantation.
Hand transplantation is not approved for all patients who have rejected an upper limb prosthesis, but patients must trial a prosthesis for at least 6 months to be considered for the procedure. Bilateral transradial amputees are considered the most appropriate candidates for hand transplants. Patients must undergo a comprehensive screening conducted by a team, including representatives from rehabilitation medicine, occupational therapy, social work and other surgical specialties. Candidates also must be approved by three psychiatric specialties: transplant, post-traumatic stress disorder and depression.
Atkins emphasized the importance of collaboration. Hand transplantation is not meant to replace a prosthesis for the majority of patients.
“It is not to be ignored that patients do very well with body powered prostheses,” Atkins said. “Of course, there is the option for advanced multi-articulating hands. Now we have a third option.”
After sharing a video interview with a bilateral hand transplant patient, Atkins said, “I think we are embarking upon a unique opportunity as professionals in our world to bring what we do in advanced upper limb prosthetics to the hand surgery and hand transplant colleagues. They are even interested in helping fund an effort that I am willing to take on, to look more specifically at functional outcomes.”
Atkins plans to publish the results of her work the Journal of Hand Surgery.
“I am committed to continue this,” she said. — by Amanda Alexander
Reference:
Atkins D. A focus on the patient experience: Advanced upper limb prosthetic rehabilitation versus hand transplantation. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; Feb. 18-21, 2015; New Orleans.
Disclosure: Atkins reports no relevant financial disclosures.
