Trans-femoral lower limb transplantation in a Sri Lankan patient: a case report and surgical technique

Arudchelvam, Joel; Ratnayake, Amila; Wijesinghe, Nuwan; Kariyawasam, Lewan; Rajakrishna, Premil; Anver, Sadath

doi:10.4038/cmj.v63i1.8624

Cited by 3 publications

(4 citation statements)

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“…The patient showed signs of mobility in his knee joint and was able to bear some weight 6 months following the transplant. A burning sensation at the level of the ankle joint was reported by the patient, which was interpreted as an early sign of sensory recovery 70 . The personal communication with the author revealed that the patient has been using his extremity with incomplete motor and sensory recovery.…”

Section: Worldwide Experience With Lower Extremity Transplantation—an...mentioning

confidence: 90%

“…In 2017, the fifth and the most recent case of lower extremity transplantation was performed in Sri Lanka by Arudchelvam et al 70,74 A 32-year-old male with an above-knee amputation was chosen as the recipient, and the donor was a 52-year-old fully HLA-mismatched male. By measuring the length of the donor thigh and the recipient's amputation stump, a premarked line was laid out to do the transplant at the mid-thigh level.…”

Section: Case 5: Unilateral Transfemoral-level Transplantation-arudch...mentioning

confidence: 99%

“…2017 Arudchelvam et al 70 Left transfemoral LET Even though the patient is ambulating, his sensory and motor recovery is incomplete. He also developed lymphedema and frequent lymphangitis of the transplanted limb.…”

Section: Table 1 Outcomes From Each Casementioning

confidence: 99%

“…burning sensation at the level of the ankle joint was reported by the patient, which was interpreted as an early sign of sensory recovery. 70 The personal communication with the author revealed that the patient has been using his extremity with incomplete motor and sensory recovery. Additionally, he has experienced frequent lymphangitis and lymphedema of the lower extremity during the 6-year follow-up.…”

Section: Table 1 Outcomes From Each Casementioning

confidence: 99%

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A World Update of Progress in Lower Extremity Transplantation

Kodali,

Janarthanan,

Sazoglu

et al. 2024

Ann Plast Surg

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The field of vascularized composite allotransplantation (VCA) is the new frontier of solid organ transplantation (SOT). VCA spans life-enhancing/life-changing procedures such as upper extremity, craniofacial (including eye), laryngeal, tracheal, abdominal wall, penis, and lower extremity transplants. VCAs such as uterus transplants are life giving unlike any other SOT. Of all VCAs that have shown successful intermediate- to long-term graft survival with functional and immunologic outcomes, lower extremity VCAs have remained largely underexplored. Lower extremity transplantation (LET) can offer patients with improved function compared to the use of conventional prostheses, reducing concerns of phantom limb pain and stump complications, and offer an option for eligible amputees that either fail prosthetic rehabilitation or do not adapt to prosthetics. Nevertheless, these benefits must be carefully weighed against the risks of VCA, which are not trivial, including the adverse effects of lifelong immunosuppression, extremely challenging perioperative care, and delayed nerve regeneration. There have been 5 lower extremity transplants to date, ranging from unilateral or bilateral to quadrimembral, progressively increasing in risk that resulted in fatalities in 3 of the 5 cases, emphasizing the inherent risks. The advantages of LET over prosthetics must be carefully weighed, demanding rigorous candidate selection for optimal outcomes.

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Section: Worldwide Experience With Lower Extremity Transplantation—an...mentioning

confidence: 90%

Section: Case 5: Unilateral Transfemoral-level Transplantation-arudch...mentioning

confidence: 99%

Section: Table 1 Outcomes From Each Casementioning

confidence: 99%

Section: Table 1 Outcomes From Each Casementioning

confidence: 99%

See 2 more Smart Citations