Vascularized Composite Allotransplantation of the Hand: A Systematic Review of Eligibility Criteria.

Autor:	Laspro M; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Onuh OC; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Carrion K; SUNY Downstate College of Medicine, New York, NY., Brydges HT; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Tran DL; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Chaya BF; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Parker A; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Thanik VD; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Sharma S; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine., Rodriguez ED; From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine.
Jazyk:	angličtina
Zdroj:	Annals of plastic surgery [Ann Plast Surg] 2023 Dec 01; Vol. 91 (6), pp. 771-778. Date of Electronic Publication: 2023 Aug 12.
DOI:	10.1097/SAP.0000000000003659
Abstrakt:	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. Competing Interests: Conflicts of interest and sources of funding: none declared. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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