First two bilateral hand transplantations in India (Part 1): From vision to reality

Iyer, Subramania; Sharma, Mohit; Kishore, P. R. S.; Mathew, Jimmy; Vijayaraghavan, Sundeep; Janarthanan, R.; Wakure, Abhijeet; Reddy, Raghuveer; Chetan, S M Mali; Varma, Visakh; Chaudhari, Ashish; Dhake, Swapnil; Omkumar, Akshay; Prasad, Vinitha

doi:10.4103/ijps.ijps_93_17

Cited by 9 publications

(17 citation statements)

References 6 publications

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“…During the coronavirus disease 2019 (COVID-19) pandemic, transplantation rates initially declined in India 5 and gradually recovered with the implementation of National Organ and Tissue Transplant Organization transplant guidelines 6,7 and the ability to cope with the pandemic. Table 2 summarizes milestones in SOT in India [8][9][10][11][12][13][14][15][16][17][18][19] Heart-Lung Transplants At the time of this report, there were <10 government institutions performing heart transplant (Figure 2B…”

Section: History and Transplant Volumes Of Live And Deceased Donor Tr...mentioning

confidence: 99%

Section: History and Transplant Volumes Of Live And Deceased Donor Tr...mentioning

confidence: 99%

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Current Status, Challenges, and Opportunities of Organ Donation and Transplantation in India

et al. 2023

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DISCREPANCY BETWEEN LIVE AND DECEASED DONOR TRANSPLANTS IN INDIAWe intend to elaborate on the current status, diversity in access, equity, and economics of solid organ transplantation (SOT) in India. Currently, India performs the third largest volume of organ transplants after the United States and China. [1][2][3] Notably, <10% of patients with organ failure have access to SOT worldwide. The Indian Ministry of Health estimates a gap of approximately 175 000 kidneys, 50 000 livers, hearts, and lungs in addition to 2500 pancreas. TheNewsletter Transplant (2018 data) reported on 12 758 patients wait-listed for kidneys, 4173 for liver, 425 for heart, 75 for lung, 48 for pancreas, and 6 for small bowel transplants (SBTs) for in India. 4 Deceased donation rates have remained stable and <1 per million population from 2013 to 2021. To achieve self-sufficiency in organ donation, the estimated deceased donation rate in India will need to achieve a rate of 62 per million population. The distinguishing feature of Indian transplant programs is their predominant reliance on living donation (87%), with only 13% of the kidney transplant volume deriving from deceased donors (DD). [1][2][3] There are also stark geographic differences in India with active DD programs in South and West India, whereas DD has not been initiated in Northeast India. Moreover, donation after the circulatory determination of death and kidney-paired exchange programs are still underdeveloped in India (<1%) and should be promoted.

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Section: History and Transplant Volumes Of Live And Deceased Donor Tr...mentioning

confidence: 99%

Section: History and Transplant Volumes Of Live And Deceased Donor Tr...mentioning

confidence: 99%

Current Status, Challenges, and Opportunities of Organ Donation and Transplantation in India

et al. 2023

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“…From those that operated only on adult populations, 12 centers established a maximum age of 60 years. 12,17,20,54,66,70,75,104,105,110,115,120 Regarding social factors, the majority of centers (71%) specifically mentioned the need for a strong support system; yet, the support system was often poorly defined. 4,12,15,17,37,54,63,69,75,76,79,88,99,115,119,120 Psychological considerations were addressed by 28 programs, all of which required thorough psychiatric screening for major psychiatriccomorbidities.…”

Section: Demographic and Psychosocial Considerationsmentioning

confidence: 99%

“…12,17,20,54,66,70,75,104,105,110,115,120 Regarding social factors, the majority of centers (71%) specifically mentioned the need for a strong support system; yet, the support system was often poorly defined. 4,12,15,17,37,54,63,69,75,76,79,88,99,115,119,120 Psychological considerations were addressed by 28 programs, all of which required thorough psychiatric screening for major psychiatriccomorbidities. 12,16,17,19,20, 32,33,37,42,50,52-55, 64,66,69,73,75,77,89,90,99, 102,105,106,110,115,119 Patient Anatomy and Limb Deficiency Discussion over the nature of the defect was central in the articles reviewed.…”

Section: Demographic and Psychosocial Considerationsmentioning

confidence: 99%

Vascularized Composite Allotransplantation of the Hand

et al. 2023

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Background Hand transplantation (HT) has emerged as an intervention of last resort for those who endured amputation or irreparable loss of upper extremity function. However, because of the considerable effort required for allograft management and the risks of lifelong immunosuppression, patient eligibility is critical to treatment success. Thus, the objective of this article is to investigate the reported eligibility criteria of HT centers globally. Methods A systematic review of the HT literature was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, using PubMed, Cochrane, Ovid/Medline, and Scopus. Program Web sites and clinicaltrials.gov entries were included where available. Results A total of 354 articles were reviewed, 101 of which met inclusion criteria. Furthermore, 10 patient-facing Web sites and 11 clinical trials were included. The most reported criteria related to the capacity to manage the allograft posttransplantation, including access to follow-up, insurance coverage, psychological stability, and history of medical compliance. Other factors related to the impact of immunosuppression, such as active pregnancy and patient immune status, were less emphasized. Conclusions Because of the novelty of the field, eligibility criteria continue to evolve. While there is consensus on certain eligibility factors, other criteria diverge between programs, and very few factors were considered absolute contraindications. As the popularity of the field continues to grow, we encourage the development of consensus evidence-based eligibility criteria.

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“…Numerous published protocols exist to direct hand therapists in the care of flexor (Starr et al, 2013) and extensor tendon repairs (Collocott et al, 2018) alongside dedicated hand transplant rehabilitation protocols (Bueno et al, 2014). With 120 or so hand transplants documented by the International Registry on Hand and composite tissue transplantation (Petruzzo et al, 2010), rehabilitation programs have been described across the globe, including India (Iyer et al, 2017), United States (Bueno et al, 2014), Australia, Poland and the United Kingdom (United Kingdom).…”

Section: Rehabilitation and System Componentsmentioning

confidence: 99%

Hand Transplants, Daily Functioning, and the Human Capacity for Limb Regeneration

Fitzpatrick

Brogan

Grover

2022

Front. Cell Dev. Biol.

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Unlike some of our invertebrate and vertebrate cousins with the capacity to regenerate limbs after traumatic loss, humans do not have the ability to regrow arms or legs lost to injury or disease. For the millions of people worldwide who have lost a limb after birth, the primary route to regaining function and minimizing future complications is via rehabilitation, prosthetic devices, assistive aids, health system robustness, and social safety net structures. The majority of limbs lost are lower limbs (legs), with diabetes and vascular disorders being significant causal contributors. Upper limbs (arms) are lost primarily because of trauma; digits and hands are the most common levels of loss. Even if much of the arm remains intact, upper limb amputation significantly impacts function, largely due to the loss of the hand. Human hands are marvels of evolution and permit a dexterity that enables a wide variety of function not readily replaced by devices. It is not surprising, therefore, for some individuals, dissatisfaction with available prosthetic options coupled with remarkable advances in hand surgery techniques is resulting in patients undertaking the rigors of a hand transplantation. While not “regeneration” in the sense of the enviable ability with which Axolotls can replace a lost limb, hand transplants do require significant regeneration of tissues and nerves. Regaining sophisticated hand functions also depends on “reconnecting” the donated hand with the areas of the human brain responsible for the sensory and motor processing required for complex actions. Human hand transplants are not without controversy and raise interesting challenges regarding the human regenerative capacity and the status of transplants for enabling function. More investigation is needed to address medical and ethical questions prior to expansion of hand transplants to a wider patient population.

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First two bilateral hand transplantations in India (Part 1): From vision to reality

Cited by 9 publications

References 6 publications

Current Status, Challenges, and Opportunities of Organ Donation and Transplantation in India

Current Status, Challenges, and Opportunities of Organ Donation and Transplantation in India

Vascularized Composite Allotransplantation of the Hand

Hand Transplants, Daily Functioning, and the Human Capacity for Limb Regeneration

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