Hand Transplantation for Functional Recovery

Not yet recruiting at 8 trial locations
OA
Overseen ByOmowunmi Afolabi, MSc. Psychology
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Yale University
Must be taking: Immunosuppressive medications
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether hand transplants can help individuals who have lost a hand above the wrist regain function. The focus is on determining if the transplanted hand remains healthy and usable over five years. Participants should have severe hand damage where prosthetics prove ineffective and must commit to long-term treatment and follow-up care. This procedure is known as Upper Extremity Vascularized Composite Allotransplantation (VCA). As an unphased trial, the study offers participants a unique opportunity to contribute to groundbreaking research that could transform future treatment options.

What prior data suggests that this protocol is safe for hand transplantation?

Research has shown that transplanting a hand or arm, known as upper extremity vascularized composite allotransplantation (VCA), offers promising results for improving function and sensation. Studies have found that recipients often experience better movement and feeling, enhancing their quality of life.

However, VCA is a complex procedure with significant risks. Past data indicate instances of losing the transplanted limb and some deaths, often due to rejection or infection. Participants in these studies needed medications to prevent their immune system from attacking the new limb, which can cause side effects.

In summary, while VCA offers potential benefits, participants must be aware of the risks and the need for ongoing medical care.12345

Why are researchers excited about this trial?

Researchers are excited about Upper Extremity Vascularized Composite Allotransplantation (VCA) because it offers a completely new approach to hand transplantation. Unlike traditional prosthetics or hand reconstruction surgeries, VCA involves transplanting not just skin and muscle, but also bone, nerves, and blood vessels from a donor, creating a more natural and functional limb. This method has the potential to restore a wide range of movement and sensation in the transplanted hand, which current options can't achieve. Additionally, VCA utilizes a standardized protocol, which could lead to more consistent and successful outcomes in patients.

What evidence suggests that upper extremity vascularized composite allotransplantation is effective for functional recovery?

Research has shown that transplanting a new arm or hand can greatly improve the quality of life for individuals who have lost a limb. In this trial, participants will undergo Upper Extremity Vascularized Composite Allotransplantation (VCA) to assess its impact on restoring feeling and movement, enabling the use of their hands again. Success stories highlight not only improved hand function but also enhanced mental and physical well-being after the transplant. Experiences from around the world support these benefits, demonstrating promising results in both function and appearance.14678

Who Is on the Research Team?

BP

Bohdan Pomahac, MD

Principal Investigator

Yale University

VG

Vijay Gorantla, MD, PhD, FRCS

Principal Investigator

Wake Forest University Health Sciences

Are You a Good Fit for This Trial?

This trial is for adults who have lost a hand or arm and are considering a hand transplant. Participants should be healthy enough for major surgery and long-term medication, and must not have conditions that would make the procedure unsafe.

Inclusion Criteria

Evidence of psychological stability and adaptive coping with attention to prior trauma, grief, and body-image disturbances; stable treatment for depression, anxiety, or PTSD is acceptable when documented and managed
Availability of adequate family, caregiver, and/or social support sufficient to assist with postoperative recovery, medication adherence, transportation, and psychosocial needs with caregiver/family information provided
Donor documented consent for VCA donation
See 15 more

Exclusion Criteria

I continue to have unrealistic expectations about transplant results despite counseling.
Smoking at time of transplantation including cigarettes, vaping, or nicotine products
Donor Public Health Service increased risk donors require case by case risk assessment, full disclosure, and documented multidisciplinary approval
See 22 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery and Initial Hospitalization

Participants undergo upper extremity vascularized composite allotransplantation and are monitored weekly during initial hospitalization

4 weeks
Weekly visits during hospitalization

Post-Surgery Monitoring

Participants are monitored for allograft survival and acute rejection incidence with regular assessments

12 months
Monthly visits for the first year

Long-term Follow-up

Participants are monitored for safety, functional outcomes, and psychosocial outcomes annually

48 months
Annual visits

What Are the Treatments Tested in This Trial?

Interventions

  • Upper Extremity Vascularized Composite Allotransplantation (VCA)

Trial Overview

The study is testing the safety, function, and psychological effects of hand or arm transplantation (VCA) over five years. All participants receive the transplant following a standardized protocol.

How Is the Trial Designed?

1

Treatment groups

Experimental Treatment

Group I: Upper Extremity Composite AllotransplantationExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials
1,963
Recruited
3,046,000+

Wake Forest University Health Sciences

Collaborator

Trials
1,432
Recruited
2,506,000+

Citations

Perceived Success in Upper-Extremity Vascularized ...

Vascularized composite allotransplantation has emerged as a revolutionary treatment option for anatomical restoration after severe disfigurement or amputation.

lessons learned from hand transplantation and implications ...

The main goal of VCA of the extremity is to improve quality of life via restoration of sensation and motor function after limb loss. All viable ...

Vascularized Composite Allotransplantation of the Hand ...

The purpose of the trial is to study functional, psychological, and immunological outcomes of human upper extremity allotransplantation. Detailed Description.

Building a Hand and Upper Extremity Transplantation Program

The emerging field of vascularized composite allotransplantation (VCA) offers promising functional and aesthetic outcomes when compared with conventional ...

Outcomes after hand and upper extremity transplantation

This review will discuss the current state of HUET, summarizing outcome data on graft survival, motor and sensory function, as well as ...

Measuring Health-Related Quality of Life in Upper ...

The current standard outcomes included in the International Registry on Hand and Composite Tissue Transplantation are limited to 1 self-report measure—the

VCA Background Information and Context - NCBI

Based on data reported hand VCA recipients showed improvement in their quantitative function scores, DASH scores, and the sensory recovery test after hand ...

essential factors for upper extremity transplant program ...

Vascularized Composite Allotransplantation (VCA) offers a unique option to restore form and function after limb loss or facial trauma that cannot be ...