Fundamentals of Hand Transplantation

Hand transplantation (HT) provides a unique treatment that restores the anatomical form and function, which may not be achieved by traditional reconstruction and prosthetics. HT belongs to a category of treatments called vascularized composite allotransplants (VCA) which are delineated from solid organ transplants by their inclusion of multiple tissue types—such as skin, bone, and muscle. Constituting the highest rung in the reconstructive ladder for its high complex technical and immunological challenges. HT requires meticulous preparation, a comprehensive interdisciplinary approach, and careful patient selection to optimize reconstructive outcomes. However, despite enhancing quality of life, hand transplantation remains controversial. In this chapter, we provide an overview, patient selection, general management, and associated complications.