5-Year Activity and Participation Outcomes of the First Successful Pediatric Bilateral Hand Transplantation: A Case Report

Abstract

Aims

Describe the 5-year outcomes of the first successful pediatric bilateral hand transplantation.

Methods

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.

Results

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.

Conclusion

The child developed hand movements for daily activities and was completing daily activities with improved efficiency. Health-related quality of life outcomes were favorable.

Keywords:

• Amputation
• composite tissue allograft
• hand transplantation
• occupational therapy
• patient-reported outcome measure
• quality of life

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Correction

Correction Statement

This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://doi.org/10.1080/01942638.2022.2113628).

Acknowledgments

We thank numerous members of the child’s transplantation team who influenced the rehabilitation plan and this report: Deb Humpl, Michelle Hsia, Kelly Ferry, Bill Gaetz, Benjamin Chang, Scott Kozin, Chris Feudtner, Chrissy Mcandrew, and Ashley Binkowski.

Disclosure Statement

We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research and work are clearly identified in the title page of the manuscript.

Additional information

Funding

This work was supported by Hansjorg Wyss Fund for Immunology; Department of Defense [W81XWH-18-2-0067].