Side-Effects and Potential Complications

  • Lionel Badet
  • Palmina Petruzzo
  • Nicole Lefrançois
  • Emmanuel Morelon
  • Xavier Martin
  • Jean-Michel Dubernard


Since the first hand transplantation carried out in September 1998, there has been a great deal of discussion concerning the potential risks inducted by the immunosuppressive therapy for the patients transplanted, as they need lifelong immunosuppression. This discussion has been particularly emotional, as composite allograft transplantations (CAT) are not considered as life saving whereas immunosuppressive therapy can expose the recipients to serious side-effects and life-threatening complications. Transplantation is routinely indicated and accepted for non-life-threatening situations, such as dialysis-dependent renal failure and poorly controlled diabetes, because it allows a significant improvement in patient’s quality of life. Consequently, the above rationale might be applied to hand transplantation when functional recovery and improvement in quality of life are demonstrated.


Mycophenolate Mofetil Posttransplant Diabetes Posttransplant Malignancy Hand Transplantation Cutaneous Mycosis 
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  1. 1.
    Baumeister S, Kleist C, Dohler B et al (2004) Risks of allogeneic hand transplantation. Microsurgery 24:98–103PubMedCrossRefGoogle Scholar
  2. 2.
    Frezza EE, Fung JJ, van Thiel DH (1999) Non-lymphoid cancer after liver transplantation. Hepatogastroenterology 44:1172–1181Google Scholar
  3. 3.
    Jain AB, Yee LD, Nalesnik MA et al (1999) Comparative incidence of de novo nonlymphoid malignancies after liver transplantation under tacrolimus using surveillance epidemiologic end result data. Transplantation 66:1193–1200CrossRefGoogle Scholar
  4. 4.
    Kinlen LJ, Sheil AG, Peto J, Doll R (1979) Collaborative United Kingdom-Australasian study of cancer in patients treated with immunosuppressive drugs. Br Med J 2:1461–1466PubMedGoogle Scholar
  5. 5.
    Opelz G, Henderson R (1993) Incidence of non-Hodgkin lymphoma in kidney and heart transplant recipients. Lancet 342:1514–1516PubMedCrossRefGoogle Scholar
  6. 6.
    Penn I (1996) Posttransplantation de novo tumors in liver allograft recipients. Liver Transpl Surg 2:52–59PubMedCrossRefGoogle Scholar
  7. 7.
    Johnson C, Ahsan N, Gonwa T et al (2000) Randomized trial of tacrolimus (Prograf) in combination with azathioprine or mycophenolate mofetil versus cyclosporine (Neoral) with mycophenolate mofetil after cadaveric kidney transplantation. Transplantation 69:834–841PubMedCrossRefGoogle Scholar
  8. 8.
    Miller J (1999) Tacrolimus and mycophenolate mofetil in renal transplant recipients: one year results of a multicenter, randomized dose ranging trial. FK506/MMF Dose-Ranging Kidney Transplant Study Group. Transplant Proc 31:276–277PubMedCrossRefGoogle Scholar
  9. 9.
    Pirsch JD, Miller J, Deierhoi MH et al (1997) A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group. Transplantation 63:977–983PubMedCrossRefGoogle Scholar
  10. 10.
    Shapiro R, Jordan ML, Scantlebury VP et al (1995) A prospective randomized trial of FK506-based immunosuppression after renal transplantation. Transplantation 59(4):485–490PubMedCrossRefGoogle Scholar
  11. 11.
    van Hooff JP, Christiaans MH, van Duijnhoven EM (2005) Tacrolimus and posttransplant diabetes mellitus in renal transplantation. Transplantation 79:1465–1469PubMedCrossRefGoogle Scholar
  12. 12.
    Lanzetta M, Petruzzo P, Margreiter R et al (2005) The international registry on hand and composite tissue transplantation. Transplantation 79:1210–1214PubMedCrossRefGoogle Scholar
  13. 13.
    Porter R, Crombie AL, Gardner PS, Uldall RP (1972) Incidence of ocular complications in patients undergoing renal transplantation. Br Med J 3:133–136PubMedCrossRefGoogle Scholar
  14. 14.
    Mathew TH (1995) A blinded, long-term, randomized multicenter study of mycophenolate mofetil in cadaveric renal transplantation: results at three years. Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group. Transplantation 65:1450–1454CrossRefGoogle Scholar
  15. 15.
    European Mycophenolate Mofetil Cooperative Study Group (1995) Placebo-controlled study of mycophenolate mofetil combined with cyclosporin and corticosteroids for prevention of acute rejection. Lancet 345:1321–1325Google Scholar
  16. 16.
    Fung JJ, Alessiani M, Abu-Elmagd K et al (1991) Adverse effects associated with the use of FK 506. Transplant Proc 23:3105–3108PubMedGoogle Scholar
  17. 17.
    McCauley J, Takaya S, Fung J et al (1991) The question of FK 506 nephrotoxicity after liver transplantation. Transplant Proc 23:1444–1447PubMedGoogle Scholar
  18. 18.
    Porayko MK, Textor SC, Krom RA et al (1994) Nephrotoxic effects of primary immunosuppression with FK-506 and cyclosporine regimens after liver transplantation. Mayo Clin Proc 69:105–111PubMedGoogle Scholar
  19. 19.
    Eidelman, BH, Abu-Elmagd K, Wilson J et al (1991) Neurologic complications of FK 506. Transplant Proc 23:3175–178PubMedGoogle Scholar
  20. 20.
    Sollinger, HW (1995) Mycophenolate mofetil for the prevention of acute rejection in primary cadaveric renal allograft recipients. U.S. Renal Transplant Mycophenolate Mofetil Study Group. Transplantation 60:225–232PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Lionel Badet
  • Palmina Petruzzo
    • 1
    • 2
  • Nicole Lefrançois
  • Emmanuel Morelon
    • 3
  • Xavier Martin
    • 1
  • Jean-Michel Dubernard
    • 1
  1. 1.Department of TransplantationÉdouard Herriot HospitalLyonFrance
  2. 2.Department of SurgeryUniversity of CagliariItaly
  3. 3.Department of Immunology and Renal Transplantation, Édouard Herriot HospitalClaude Bernard Lyon 1 UniversityLyonFrance

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