CC BY 4.0 · Arch Plast Surg 2023; 50(04): 415-421
DOI: 10.1055/a-2059-5570
Hand/Peripheral Nerve
Case Report

One Year Experience of the Hand Allotransplantation First Performed after Korea Organ Transplantation Act (KOTA) Amendment

1   Department of Plastic & Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Korea
2   Institute for Human Tissue Restoration, Yonsei University, College of Medicine, Seoul, Korea
,
1   Department of Plastic & Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Korea
2   Institute for Human Tissue Restoration, Yonsei University, College of Medicine, Seoul, Korea
,
3   Department of Orthopedic Surgery, Yonsei University, College of Medicine, Seoul, Korea
6   Transplantation Center, Yonsei University, College of Medicine, Seoul, Korea
,
4   Department of Surgery, Yonsei University, College of Medicine, Seoul, Korea
5   Department of Transplantation Surgery, Yonsei University, College of Medicine, Seoul, Korea
6   Transplantation Center, Yonsei University, College of Medicine, Seoul, Korea
,
1   Department of Plastic & Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Korea
2   Institute for Human Tissue Restoration, Yonsei University, College of Medicine, Seoul, Korea
,
1   Department of Plastic & Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Korea
2   Institute for Human Tissue Restoration, Yonsei University, College of Medicine, Seoul, Korea
6   Transplantation Center, Yonsei University, College of Medicine, Seoul, Korea
› Author Affiliations
Funding This study was supported by the Severance Hospital Research Fund for Clinical Excellence (SHRC; grant number: C-2020-0019).

Abstract

The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

Ethical Approval

The informed consent form was approved by the institutional review board of Severance Hospital (IRB approval number 4-2022-0668).


Authors' Contributions

Conceptualization: J.W.H., Y.R.C., and D.J.J.

Data curation: J.W.H., Y.R.C., D.J.J, and N.L.

Methodology: J.W.H., Y.R.C., and D.J.J.

Validation: J.W.H. and W.J.L.

Investigation: J.W.H., W.Y.B., Y.R.C, and D.J.J.

Writing-original draft: N.L and .J.W.H.

Writing- review and editing: N.L and J.W.H.


Patient Consent

We obtained written informed consent from the patient for publication and academic purpose.




Publication History

Received: 27 October 2022

Accepted: 19 February 2023

Accepted Manuscript online:
21 March 2023

Article published online:
02 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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