Hand transplantation: The louisville experience

Abstract

In February 1964, Dr. Roberto Gilbert Elizalde performed a right forearm transplant on a 28-year-old sailor with a blast injury, laying the foundation to the field of hand transplantation. However, it was not until September 1991, that the first conference on composite tissue allotransplantation (CTA) was held in Washington, DC to determine the clinical feasibility of transplanting limbs in patients with limb loss and the direction in which clinically oriented limb transplantation research should head. In June 1996, we organized a team of surgeons comprising hand, plastic, and transplant specialties along with members representing transplant psychiatry, pathology, tissue typing, hand therapy, and organ procurement. This constituted the Louisville Hand Transplant team. In November 1997, the First International Symposium on Composite Tissue Allotransplantation was convened in Louisville, Kentucky. The goal of this meeting was to discuss the scientific, clinical and ethical barriers standing in the way of performing the first human hand transplant. International experts at the meeting predicted that limb allotransplantation was not far from becoming a clinical reality. In September 1998, 34 years after the first hand transplant, surgeons in Lyon, France, performed the world's second hand transplant.