Home > Comprehensive Transplant Center > Programs > Reconstructive Transplant

Reconstructive Transplant

Why would I need a reconstructive hand transplant?
Am I eligible for a hand transplant?
How long will I have to wait for a transplant?
How do you find hand transplant donors? Is that included in the organ donation box on my driver's license?
What is the surgery like?
What is rehabilitation like?
Is there an active study related for hand transplants?

Reconstructive transplant, also known as composite tissue transplantation or composite tissue allograft, is the transfer of an external feature or limb from one individual to another. This includes transplanting skin, muscles and tendons, nerves, bone and blood vessels. Reconstructive transplants have been performed on hands, faces, abdominal walls, and other parts of the body.

Currently at the Johns Hopkins Comprehensive Transplant Center, we are working specifically with hand transplant patients, giving them new opportunities and hope for the future.

Find out more about tissue transfer from the
Johns Hopkins Plastic and Reconstructive Surgery Department.

Why would I need a reconstructive hand transplant?

Reconstructive hand transplants are for adults who have suffered a hand/arm amputation or extreme loss of function due to injury or illness. You may consider such a transplant if you have almost no function of your hands and are not a candidate for alternative or conventional reconstructive surgery. You may be a candidate for reconstructive transplant if you have lost either one hand or both at any level from the hand to the upper arm. Individuals who have only lost fingers or have lost the entire arm from the shoulder are not currently eligible for this type of transplant.

Am I eligible for a hand transplant?

To be eligible for a hand transplant, you must meet the following criteria. This criteria is a general list and in order to determine full eligibility, you should meet with the reconstructive transplant team.

18 – 69 years of age
Amputation at the middle of the upper arm or below
No history of HIV or hepatitis C
Able to take immunosuppressive drugs
No history of cancer for at least five years
Willingness to forgo pregnancy for one year

How long will I have to wait for a transplant?

Once you are approved for a hand transplant, you will have to wait for a matching donor to become available. This can range from a few weeks to several months. The donor must have matching blood and tissue types as well as matching skin color, skin tone, gender, ethnicity, race and size of hand.

How do you find hand transplant donors? Is that included in the organ donation box on my driver’s license?

Hand donation is not included in the commonly used driver’s license organ donation registry. Hand donation involves a special and sensitive consent process with donor families. For Johns Hopkins patients, this process is facilitated through specially trained and experience coordinators from the Living Legacy Foundation of Maryland, which is the organ procurement organization for the state of Maryland (with the exception of Charles, Montgomery and Prince Georges counties, which are covered by the Washington Regional Transplant Community).

In addition to matching blood type and immunological parameters like in solid organ transplantation, hand donation involves several additional parameters such as gender, age, size of the hand, skin color and tone to ensure optimal matching between donor and recipient.

What is the surgery like?

Patients waiting for a hand donation can be called into the hospital for surgery at any time. Hand transplant surgery typically takes 8 – 14 hours. After surgery, you will be placed in a surgical intensive care unit (SICU) for several days. Once the surgical team feels comfortable with you being moved out of the SICU, you will move to a transplant unit, where you will receive care specially designed for all types of transplant patients. You can expect to be in the hospital anywhere from four weeks to three months. The amount of time spent in the hospital depends on a number of factors, including the amount of support and assistance you have at home, the distance from your home to the hospital for follow-up care, and any delays that might occur in recovery.

What is rehabilitation like?

Hand transplant patients should be prepared for an intensive rehabilitation process. You will be involved in some form of rehabilitation for the rest of your life. All patients will be required to attend directed hand therapy for 6+ hours each day, 5 days a week, for the first 3-6 months after the transplant. Therapy will be tailored to your needs and abilities, however you should understand that caring for and rehabilitating transplanted hands becomes a full-time job for the first 1-2 years.