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Rehabilitative Surgery pp 275–280Cite as

Hand Transplantation and Rehabilitation

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Abstract

Hand transplantation is a unique procedure whose success depends heavily on the occupational therapist. An additional challenge to the hand outcome is immunosuppression and immunomodulation; therapists play a vital role in identifying a rejection episode early, since he or she most closely examines the patient’s hands on a daily basis. Rejection can appear as a rash that could be spotty, patchy, or blotchy. Unlike internal organ transplants, where rejection is difficult to spot early, it is easy to detect and monitor in the hand, allowing for early medical intervention. During the first 3–6 months, an intense rehabilitation protocol has to be implemented in all patients with 3–6 h of supervised occupational therapy 5 days a week, depending on the nature and level of the transplant. A phenomenon of cortical plasticity and neurointegration occurs after upper extremity transplantation in which portions of the recipient’s brain are reassigned to control the limb.

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Author information

Authors and Affiliations

  1. The Plastic Surgery Center, Institute for Advanced Reconstruction, 535 Sycamore Ave, Shrewsbury, NJ, 07702, USA

    Eric G. Wimmers MD

  2. Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MA, USA

    Justin M. Sacks MD, FACS

  3. Vascularized Composite Allograft Transplant Laboratory, Carey School of Business, Johns Hopkins Outpatient Center, Johns Hopkins University, 601 North Caroline Street Suite 2114C, Baltimore, MA, 21287, USA

    Justin M. Sacks MD, FACS

Authors
  1. Eric G. Wimmers MD
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  2. Justin M. Sacks MD, FACS
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Corresponding author

Correspondence to Eric G. Wimmers MD .

Editor information

Editors and Affiliations

  1. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Andrew I. Elkwood

  2. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Matthew Kaufman

  3. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Lisa F. Schneider

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© 2017 Springer International Publishing Switzerland

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Wimmers, E.G., Sacks, J.M. (2017). Hand Transplantation and Rehabilitation. In: Elkwood, A., Kaufman, M., Schneider, L. (eds) Rehabilitative Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-41406-5_21

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  • DOI: https://doi.org/10.1007/978-3-319-41406-5_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41404-1

  • Online ISBN: 978-3-319-41406-5

  • eBook Packages: MedicineMedicine (R0)

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