First human double hand transplantation: efficacy of a conventional immunosuppressive protocol.

Abstract:

:Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33-yr-old man suffering from a traumatic amputation of both hands in 1996. Five HLA-A, -B, and -DR mismatches were present with the donor; T and B cell cross-match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti-HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side-effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft-versus-host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Petruzzo P,Revillard JP,Kanitakis J,Lanzetta M,Hakim NS,Lefrançois N,Owen E,Dubernard JM

doi

10.1034/j.1399-0012.2003.00005.x

subject

Has Abstract

pub_date

2003-10-01 00:00:00

pages

455-60

issue

5

eissn

0902-0063

issn

1399-0012

journal_volume

17

pub_type

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