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Hand Transplant

Vascularized Composite Allotransplantation

Fewer than 300 people in the world have received hand transplants. The head of our hand transplant program participated in the first two hand transplants performed in the U.S., in 1999 and 2001. Since then, fewer than 100 hand transplants have been performed in the U.S. Our comprehensive approach guides our research on hand transplantation, which remains an investigational procedure. It is an option for people who have lost one or both hands.

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Before Your Hand Transplant

During your extensive evaluation, we discuss functional outcome, treatment options, risks, alternatives, benefits, and complications, as well as the need for immunosuppressive medication to prevent rejection. If you choose to pursue a hand transplant, multiple tests and screening procedures are necessary.

Blood and Tissue Tests

These tests check blood type and compatibility, assess organ and immune system function, and screen for viruses or infections that could affect your outcome.

Psychosocial Evaluation

We assess your social support and other parameters to understand how well you have dealt with the loss of your limb and the status of your overall well-being.

Rehabilitation Evaluation

This evaluation determines the function you currently have in your residual limb.

Imaging Tests

MRI and X-ray bone scans are performed to evaluate your residual limb.

Involving Your Caregivers

We involve your designated caregivers -- family members or friends -- from the time of your first evaluation. We educate them about their important role in caring for you after your hand transplant.

Preparing for Your Hand Transplant

All hand transplant candidates participate in transplant education to help you and your caregivers learn about the process, the medications you need to take, and the recovery process.

Waiting for Your Hand Transplant

You will be notified when a suitable donor hand is available. Donors for a limb have been donors of other organs as well. If you live outside of the Durham area, our team can assist you in gathering the resources and support you need.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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After Your Hand Transplant

Preventing Organ Rejection

Although organ rejection happens after transplants, we use innovative strategies and research to prevent rejection and injury. We provide you and your caregivers resources and support to help you live a healthy life after transplantation. Our team is always available to answer your questions and address your concerns.

Extensive Rehabilitation

Our rehabilitation therapy specialists start working with you almost immediately after your surgery and will continue to provide intensive therapy designed to maximize the functional outcome of your new hand or hands. We help you adapt to the feeling and function of your new hand or hands and teach you to use them for everyday activities. You will wear different splints or braces for at least one year to protect your new hand while you are undergoing therapy.

Ongoing Support

You and your loved ones will be able to speak with other transplant recipients and their families, ask questions, and share information about issues related to the transplant experience.

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Hand Transplantation Expertise

Leader in Vascularized Allotransplantation (VCA)
Duke’s hand transplant program is headed by one of the world’s leaders in vascularized composite allotransplantation (VCA), an innovative method of transplanting multiple tissues -- such as those of a hand -- as a functional unit. Our hand transplant surgeon is trained in microsurgery, hand surgery, and transplant surgery and participated in the establishment of the first hand transplant program in the U.S. Our lead surgeon also participates in the development of guidelines for the safe implementation of VCA in the U.S.

Active Research Team
Our hand transplantation team conducts research that is helping doctors understand how to minimize rejection, develop new immunosuppressive therapy approaches, and diagnose skin rejection and other tissues' responses following a transplant. Our basic, clinical, and translational (meaning how we apply our lab research to patient care) research guides our systematic approach to hand transplantation.

Currently Recruiting for Clinical Trial
We are currently recruiting people to participate in a study to determine the safety and efficacy of hand transplantation as a treatment for people with loss of limb below the elbow. You may be a candidate for evaluation if you have lost a limb, are between the ages of 18 and 65, and are willing to travel to Duke.

Team of Dedicated Specialists
We work with many Duke specialists in the fields of transplantation, orthopaedics, hand surgery, microsurgery, plastic surgery, immunology, and anesthesiology. Our team also includes mental health and rehabilitation specialists, specially trained nurses, social workers, and support staff. Together, we help you through the process from the beginning, minimize your risk of rejection and helping you work toward the best possible outcome.

Support for the Future
Learning to live with a transplanted limb is an ongoing process that includes extensive physical and occupational therapy, mental health support, and social work services. We support you as you adapt to the feeling and function of your new hand or hands.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2025–2026.

Patient Resources

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This page was medically reviewed on 08/09/2022 by

Linda Carime Cendales, MD | Hand Surgeon