Linda Cendales, MD, is a specialist in hand transplantation.
If you have lost one or both hands, you may be a candidate for a hand transplant. This surgical approach is being researched and is part of a new category of organ transplants known as vascularized composite allotransplantation (VCA). This refers to the transplantation of tissues, including skin, nerves, muscles, and bone as a singular, functional unit. Linda Cendales, MD, is one of the first surgeons in the U.S. to perform a hand transplant and is now leading the research on this new procedure at Duke. Here, she explains part of the process if you are considering hand transplantation.
Should I consider a hand transplant?
Deciding to pursue a hand transplant is a serious undertaking. There are lifelong implications including the benefits of having a hand or hands versus the risks related to surgery and the need to take immunosuppressive medications to help prevent rejection of the hand transplant for as long as you have the transplant.
Typically, people who have undergone a hand transplant have lost one or both hands in a trauma, such as an accident. People who seek hand transplantation want to improve their quality of life by being better able to perform activities they couldn’t perform with a residual limb or prosthesis.
Our goal is to evaluate whether a hand transplant will improve your ability to function better compared to before the transplant. How much function you experience depends on multiple factors including the nature of your original injury, the level of amputation, and the type of reconstruction needed during the hand transplant surgery.
Could I be a candidate for a hand transplant?
Anyone between the ages of 18 and 65 who has lost one or both hands below the elbow may be a candidate for this study. It doesn’t matter how long ago the amputation/limb loss took place.
How is someone chosen to participate in the research?
You will undergo a thorough evaluation, including extensive testing. The results are reviewed by a team that includes many specialists. Together, we determine if you are approved to move forward with the transplant.
How long is the hand transplant operation?
Hand transplantation is a complex procedure that can last an average of 15 hours. The exact length depends on the nature of the reconstruction. Your team will involve many surgeons, doctors, and skilled operating room personnel who will rotate in and out throughout the procedure. After the surgery, you must undergo extensive post-transplant rehabilitation.
What is the success rate of the procedure?
Currently, fewer than 300 people have undergone hand transplants worldwide, and fewer than 100 in the U.S. People who have received hand transplants report that they have recovered some degree of sensation and can perform activities with the hand transplant they could not do before.
Why should I come to Duke for a hand transplant?
Only a few transplant centers in the world are equipped with the expertise and technology to perform this complex procedure. Our experience with hand transplantation, track record in research, outstanding patient care, and team approach to surgical innovations allow us to offer this comprehensive research therapy.