Hand transplantation is a relatively new option for individuals who have lost one or both hands due to illness or trauma. Hand transplantation is a type of vascularized composite allotransplantation (VCA). VCA refers to the transplantation of multiple tissues, such as skin, muscle, tendon, nerve, and bone, as a functional unit (e.g., a hand). This type of surgery is currently under investigation.
Directed by a leading expert in VCA, the Duke Hand Transplantation Program amalgamates a multidisciplinary team of world-renowned specialists in transplantation, orthopedics, hand surgery, microsurgery, plastic surgery, immunology, anesthesiology, mental health, and physical rehabilitation. For eligible patients, the program aims to provide a functional limb, prevent rejection of the limb, and minimize the need for immunosuppressive therapy.
The Duke Hand Transplantation Program is led by Linda Cendales, MD, a pioneer in VCA and hand transplant surgery. Dr. Cendales helped organize the team that performed the first two hand transplants in the United States in 1999 and 2001, and is the only person in the United States with formal training in hand, microsurgery, and transplant surgery. Additionally, Dr. Cendales contributes to the development of guidelines for the safe implementation of VCA in the United States.
The Duke Hand Transplantation Program is dedicated to basic, clinical, and translational research to advance our understanding of VCA and to improve patient outcomes.
The program's current research efforts in VCA are as follows:
- Basic Science -- The team has developed a preclinical model to study the mechanisms of rejection and the specificities of vascularized composite allografts compared with other solid organ transplants.
- Translational Research -- The team has established a separate preclinical VCA model to study the histopathology of rejection and to test new approaches to minimize immunosuppressive regimens.
- Clinical Research -- The program is actively recruiting participants for a clinical trial in hand transplantation. To learn more about this clinical trial, please visit the ClinicalTrials.gov website [NCT02310867]
An important aspect of the program's mission is to train the next generation of surgeons. The Microsurgical Techniques and Skills training course is available to all professionals who seek training in the use of the operating microscope and associated microsurgical instruments and procedures.