First human double hand transplantation: efficacy of a conventional immunosuppressive protocol
Identifieur interne : 000A52 ( Istex/Corpus ); précédent : 000A51; suivant : 000A53First human double hand transplantation: efficacy of a conventional immunosuppressive protocol
Auteurs : Palmina Petruzzo ; Jean Pierre Revillard ; Jean Kanitakis ; Marco Lanzetta ; Nadey S. Hakim ; Nicole Lefrançois ; Earl Owen ; Jean Michel DubernardSource :
- Clinical Transplantation [ 0902-0063 ] ; 2003-10.
English descriptors
- KwdEn :
- Acute rejection, Acute rejection episodes, Allograft, Blood levels, Cell population, Clin transplant, Composite tissue allotransplantation, Comprehensive review, Conventional immunosuppression, Cortical reorganization, Dermal axons, Double hand transplantation, Dubernard, Experimental studies, Functional recovery, Graft, Graft survival, Grafted, Hair follicles, Hand surg, Hand transplantation, Hand transplantations, Human hand allograft, Immunosuppression, Immunosuppressive, Immunosuppressive protocol, Infectious complications, Langerhans cells, Lymphocyte, Merkel cells, Mofetil therapy, Mycophenolate mofetil, Myoelectric prostheses, Nerve regeneration, Neurosci lett, Normal values, Other complications, Peripheral blood, Plast reconstr surg, Plast surg, Primate, Primate model, Primate models, Proc, Protocol, Reconstr microsurg, Rhesus monkey, Serum sickness, Skin biopsies, Surg, Tissue transplants, Transplant, Transplant proc, Transplantation, Traumatic amputation, Upper extremity reconstruction.
- Teeft :
- Acute rejection, Acute rejection episodes, Allograft, Blood levels, Cell population, Clin transplant, Composite tissue allotransplantation, Comprehensive review, Conventional immunosuppression, Cortical reorganization, Dermal axons, Double hand transplantation, Dubernard, Experimental studies, Functional recovery, Graft, Graft survival, Grafted, Hair follicles, Hand surg, Hand transplantation, Hand transplantations, Human hand allograft, Immunosuppression, Immunosuppressive, Immunosuppressive protocol, Infectious complications, Langerhans cells, Lymphocyte, Merkel cells, Mofetil therapy, Mycophenolate mofetil, Myoelectric prostheses, Nerve regeneration, Neurosci lett, Normal values, Other complications, Peripheral blood, Plast reconstr surg, Plast surg, Primate, Primate model, Primate models, Proc, Protocol, Reconstr microsurg, Rhesus monkey, Serum sickness, Skin biopsies, Surg, Tissue transplants, Transplant, Transplant proc, Transplantation, Traumatic amputation, Upper extremity reconstruction.
Abstract
Abstract: Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33‐yr‐old man suffering from a traumatic amputation of both hands in 1996. Five HLA‐A, ‐B, and ‐DR mismatches were present with the donor; T and B cell cross‐match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti‐HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side‐effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft‐versus‐host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.
Url:
DOI: 10.1034/j.1399-0012.2003.00005.x
Links to Exploration step
ISTEX:38A09461F6EF4A39CA0A645DFD108A01561DFC2FLe document en format XML
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Hakim</name><affiliation><mods:affiliation> Transplantation Unit, St Mary's Hospital, London, UK,</mods:affiliation></affiliation></author><author><name sortKey="Lefrancois, Nicole" sort="Lefrancois, Nicole" uniqKey="Lefrancois N" first="Nicole" last="Lefrançois">Nicole Lefrançois</name><affiliation><mods:affiliation> Service de Médecine de Transplantation Hôpital Edouard Herriot, Lyon, France and</mods:affiliation></affiliation></author><author><name sortKey="Owen, Earl" sort="Owen, Earl" uniqKey="Owen E" first="Earl" last="Owen">Earl Owen</name><affiliation><mods:affiliation> Microsearch Foundation of Australia and Outer Sydney Hand and Microsurgery Unit, Sydney, Australia</mods:affiliation></affiliation></author><author><name sortKey="Dubernard, Jean Michel" sort="Dubernard, Jean Michel" uniqKey="Dubernard J" first="Jean Michel" last="Dubernard">Jean Michel Dubernard</name><affiliation><mods:affiliation> Service de Chirurgie de Transplantation,</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Clinical Transplantation</title><title level="j" type="alt">CLINICAL TRANSPLANTATION</title><idno type="ISSN">0902-0063</idno><idno type="eISSN">1399-0012</idno><imprint><biblScope unit="vol">17</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="455">455</biblScope><biblScope unit="page" to="460">460</biblScope><biblScope unit="page-count">6</biblScope><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2003-10">2003-10</date></imprint><idno type="ISSN">0902-0063</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0902-0063</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute rejection</term><term>Acute rejection episodes</term><term>Allograft</term><term>Blood levels</term><term>Cell population</term><term>Clin transplant</term><term>Composite tissue allotransplantation</term><term>Comprehensive review</term><term>Conventional immunosuppression</term><term>Cortical reorganization</term><term>Dermal axons</term><term>Double hand transplantation</term><term>Dubernard</term><term>Experimental studies</term><term>Functional recovery</term><term>Graft</term><term>Graft survival</term><term>Grafted</term><term>Hair follicles</term><term>Hand surg</term><term>Hand transplantation</term><term>Hand transplantations</term><term>Human hand allograft</term><term>Immunosuppression</term><term>Immunosuppressive</term><term>Immunosuppressive protocol</term><term>Infectious complications</term><term>Langerhans cells</term><term>Lymphocyte</term><term>Merkel cells</term><term>Mofetil therapy</term><term>Mycophenolate mofetil</term><term>Myoelectric prostheses</term><term>Nerve regeneration</term><term>Neurosci lett</term><term>Normal values</term><term>Other complications</term><term>Peripheral blood</term><term>Plast reconstr surg</term><term>Plast surg</term><term>Primate</term><term>Primate model</term><term>Primate models</term><term>Proc</term><term>Protocol</term><term>Reconstr microsurg</term><term>Rhesus monkey</term><term>Serum sickness</term><term>Skin biopsies</term><term>Surg</term><term>Tissue transplants</term><term>Transplant</term><term>Transplant proc</term><term>Transplantation</term><term>Traumatic amputation</term><term>Upper extremity reconstruction</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Acute rejection</term><term>Acute rejection episodes</term><term>Allograft</term><term>Blood levels</term><term>Cell population</term><term>Clin transplant</term><term>Composite tissue allotransplantation</term><term>Comprehensive review</term><term>Conventional immunosuppression</term><term>Cortical reorganization</term><term>Dermal axons</term><term>Double hand transplantation</term><term>Dubernard</term><term>Experimental studies</term><term>Functional recovery</term><term>Graft</term><term>Graft survival</term><term>Grafted</term><term>Hair follicles</term><term>Hand surg</term><term>Hand transplantation</term><term>Hand transplantations</term><term>Human hand allograft</term><term>Immunosuppression</term><term>Immunosuppressive</term><term>Immunosuppressive protocol</term><term>Infectious complications</term><term>Langerhans cells</term><term>Lymphocyte</term><term>Merkel cells</term><term>Mofetil therapy</term><term>Mycophenolate mofetil</term><term>Myoelectric prostheses</term><term>Nerve regeneration</term><term>Neurosci lett</term><term>Normal values</term><term>Other complications</term><term>Peripheral blood</term><term>Plast reconstr surg</term><term>Plast surg</term><term>Primate</term><term>Primate model</term><term>Primate models</term><term>Proc</term><term>Protocol</term><term>Reconstr microsurg</term><term>Rhesus monkey</term><term>Serum sickness</term><term>Skin biopsies</term><term>Surg</term><term>Tissue transplants</term><term>Transplant</term><term>Transplant proc</term><term>Transplantation</term><term>Traumatic amputation</term><term>Upper extremity reconstruction</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract: Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33‐yr‐old man suffering from a traumatic amputation of both hands in 1996. Five HLA‐A, ‐B, and ‐DR mismatches were present with the donor; T and B cell cross‐match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti‐HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side‐effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft‐versus‐host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>transplantation</json:string><json:string>immunosuppression</json:string><json:string>allograft</json:string><json:string>immunosuppressive</json:string><json:string>hand transplantation</json:string><json:string>lymphocyte</json:string><json:string>immunosuppressive protocol</json:string><json:string>dubernard</json:string><json:string>surg</json:string><json:string>grafted</json:string><json:string>transplant proc</json:string><json:string>proc</json:string><json:string>double hand transplantation</json:string><json:string>functional recovery</json:string><json:string>graft</json:string><json:string>primate</json:string><json:string>composite tissue allotransplantation</json:string><json:string>experimental studies</json:string><json:string>acute rejection</json:string><json:string>human hand allograft</json:string><json:string>primate models</json:string><json:string>serum sickness</json:string><json:string>merkel cells</json:string><json:string>nerve regeneration</json:string><json:string>hand transplantations</json:string><json:string>peripheral blood</json:string><json:string>transplant</json:string><json:string>protocol</json:string><json:string>clin transplant</json:string><json:string>myoelectric prostheses</json:string><json:string>blood levels</json:string><json:string>mycophenolate mofetil</json:string><json:string>cell population</json:string><json:string>normal values</json:string><json:string>other complications</json:string><json:string>langerhans cells</json:string><json:string>hair follicles</json:string><json:string>dermal axons</json:string><json:string>skin biopsies</json:string><json:string>infectious complications</json:string><json:string>acute rejection episodes</json:string><json:string>cortical reorganization</json:string><json:string>rhesus monkey</json:string><json:string>plast reconstr surg</json:string><json:string>conventional immunosuppression</json:string><json:string>traumatic amputation</json:string><json:string>mofetil therapy</json:string><json:string>tissue transplants</json:string><json:string>upper extremity reconstruction</json:string><json:string>hand surg</json:string><json:string>comprehensive review</json:string><json:string>reconstr microsurg</json:string><json:string>neurosci lett</json:string><json:string>graft survival</json:string><json:string>plast surg</json:string><json:string>primate model</json:string></teeft></keywords><author><json:item><name>Palmina Petruzzo</name><affiliations><json:string>Service de Chirurgie de Transplantation,</json:string></affiliations></json:item><json:item><name>Jean Pierre Revillard</name><affiliations><json:string>INSERM U503,</json:string></affiliations></json:item><json:item><name>Jean Kanitakis</name><affiliations><json:string>Service de Dermatologie Hôpital Edouard Herriot, Lyon, France,</json:string></affiliations></json:item><json:item><name>Marco Lanzetta</name><affiliations><json:string>Hand Surgery and Reconstructive Microsurgery San Gerardo Hospital, University of Milano Bicocca, Monza, Italy,</json:string></affiliations></json:item><json:item><name>Nadey S Hakim</name><affiliations><json:string>Transplantation Unit, St Mary's Hospital, London, UK,</json:string></affiliations></json:item><json:item><name>Nicole Lefrançois</name><affiliations><json:string>Service de Médecine de Transplantation Hôpital Edouard Herriot, Lyon, France and</json:string></affiliations></json:item><json:item><name>Earl Owen</name><affiliations><json:string>Microsearch Foundation of Australia and Outer Sydney Hand and Microsurgery Unit, Sydney, Australia</json:string></affiliations></json:item><json:item><name>Jean Michel Dubernard</name><affiliations><json:string>Service de Chirurgie de Transplantation,</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>composite tissue allograft</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hand transplantation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>immunosuppression</value></json:item></subject><articleId><json:string>CTR005</json:string></articleId><arkIstex>ark:/67375/WNG-FJ7R4QJX-G</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>caseStudy</json:string></originalGenre><abstract>Abstract: Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33‐yr‐old man suffering from a traumatic amputation of both hands in 1996. Five HLA‐A, ‐B, and ‐DR mismatches were present with the donor; T and B cell cross‐match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti‐HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side‐effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft‐versus‐host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.</abstract><qualityIndicators><refBibsNative>true</refBibsNative><abstractWordCount>207</abstractWordCount><abstractCharCount>1529</abstractCharCount><keywordCount>3</keywordCount><score>7.637</score><pdfWordCount>3153</pdfWordCount><pdfCharCount>21158</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595 x 782 pts</pdfPageSize></qualityIndicators><title>First human double hand transplantation: efficacy of a conventional immunosuppressive protocol</title><pmid><json:string>14703930</json:string></pmid><genre><json:string>case-report</json:string></genre><host><title>Clinical Transplantation</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1399-0012</json:string></doi><issn><json:string>0902-0063</json:string></issn><eissn><json:string>1399-0012</json:string></eissn><publisherId><json:string>CTR</json:string></publisherId><volume>17</volume><issue>5</issue><pages><first>455</first><last>460</last><total>6</total></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2003</json:string><json:string>1996</json:string></date><geogName></geogName><orgName><json:string>China, Italy</json:string><json:string>Hospital, London, UK</json:string><json:string>University of Wisconsin</json:string><json:string>Microsearch Foundation of Australia and Outer Sydney</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Marco Lanzettad</json:string><json:string>H. Parmentier</json:string><json:string>A. Sirigu</json:string><json:string>M. Dawahra</json:string><json:string>Jean-Pierre Revillard</json:string><json:string>Jean Kanitakisc</json:string><json:string>G. Burloux</json:string><json:string>X. Martin</json:string><json:string>Jean Michel</json:string><json:string>Edouard Herriot</json:string><json:string>P. Giraux</json:string><json:string>D. Beckmann</json:string><json:string>Jean Pierre</json:string><json:string>M.C. Bonacci</json:string></persName><placeName><json:string>Australia</json:string><json:string>France</json:string><json:string>Sydney</json:string><json:string>Lyon</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Petruzzo et al.</json:string><json:string>Stark et al.</json:string><json:string>Daniel et al.</json:string><json:string>Stevens et al.</json:string><json:string>Lee et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-FJ7R4QJX-G</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - transplantation</json:string><json:string>2 - surgery</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - surgery</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Transplantation</json:string></scopus></categories><publicationDate>2003</publicationDate><copyrightDate>2003</copyrightDate><doi><json:string>10.1034/j.1399-0012.2003.00005.x</json:string></doi><id>38A09461F6EF4A39CA0A645DFD108A01561DFC2F</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/38A09461F6EF4A39CA0A645DFD108A01561DFC2F/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/38A09461F6EF4A39CA0A645DFD108A01561DFC2F/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/38A09461F6EF4A39CA0A645DFD108A01561DFC2F/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">First human double hand transplantation: efficacy of a conventional immunosuppressive protocol</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2003-10"></date></publicationStmt><notesStmt><note type="content-type" subtype="case-report" source="caseStudy" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-29919SZJ-6">case-report</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="case-report"><analytic><title level="a" type="main">First human double hand transplantation: efficacy of a conventional immunosuppressive protocol</title><title level="a" type="short">Immunosuppression in double hand graft</title><author xml:id="author-0000"><persName><forename type="first">Palmina</forename><surname>Petruzzo</surname></persName><affiliation> Service de Chirurgie de Transplantation,</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Jean Pierre</forename><surname>Revillard</surname></persName><affiliation> INSERM U503,</affiliation><note type="foot">
Prof Jean‐Pierre Revillard died on June 2, 2003 and the authors dedicate this manuscript to him.</note></author><author xml:id="author-0002"><persName><forename type="first">Jean</forename><surname>Kanitakis</surname></persName><affiliation>Service de Dermatologie Hôpital Edouard Herriot, Lyon, France,<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Marco</forename><surname>Lanzetta</surname></persName><affiliation> Hand Surgery and Reconstructive Microsurgery San Gerardo Hospital, University of Milano Bicocca, Monza, Italy,<address><country key="IT"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Nadey S</forename><surname>Hakim</surname></persName><affiliation> Transplantation Unit, St Mary's Hospital, London, UK,<address><country key="GB"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Nicole</forename><surname>Lefrançois</surname></persName><affiliation> Service de Médecine de Transplantation Hôpital Edouard Herriot, Lyon, France and<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Earl</forename><surname>Owen</surname></persName><affiliation> Microsearch Foundation of Australia and Outer Sydney Hand and Microsurgery Unit, Sydney, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0007"><persName><forename type="first">Jean Michel</forename><surname>Dubernard</surname></persName><affiliation> Service de Chirurgie de Transplantation,</affiliation></author><idno type="istex">38A09461F6EF4A39CA0A645DFD108A01561DFC2F</idno><idno type="ark">ark:/67375/WNG-FJ7R4QJX-G</idno><idno type="DOI">10.1034/j.1399-0012.2003.00005.x</idno><idno type="unit">CTR005</idno><idno type="toTypesetVersion">file:CTR.CTR005.pdf</idno></analytic><monogr><title level="j" type="main">Clinical Transplantation</title><title level="j" type="alt">CLINICAL TRANSPLANTATION</title><idno type="pISSN">0902-0063</idno><idno type="eISSN">1399-0012</idno><idno type="book-DOI">10.1111/(ISSN)1399-0012</idno><idno type="book-part-DOI">10.1111/ctr.2003.17.issue-5</idno><idno type="product">CTR</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">17</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="455">455</biblScope><biblScope unit="page" to="460">460</biblScope><biblScope unit="page-count">6</biblScope><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2003-10"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Abstract:</hi> Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33‐yr‐old man suffering from a traumatic amputation of both hands in 1996. Five HLA‐A, ‐B, and ‐DR mismatches were present with the donor; T and B cell cross‐match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti‐HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side‐effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft‐versus‐host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">composite tissue allograft</term><term xml:id="k2">hand transplantation</term><term xml:id="k3">immunosuppression</term></keywords><keywords rend="tocHeading1"><term>Case Reports</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/38A09461F6EF4A39CA0A645DFD108A01561DFC2F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Munksgaard International Publishers</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1399-0012</doi><issn type="print">0902-0063</issn><issn type="electronic">1399-0012</issn><idGroup><id type="product" value="CTR"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="CLINICAL TRANSPLANTATION">Clinical Transplantation</title></titleGroup></publicationMeta><publicationMeta level="part" position="10005"><doi origin="wiley">10.1111/ctr.2003.17.issue-5</doi><numberingGroup><numbering type="journalVolume" number="17">17</numbering><numbering type="journalIssue" number="5">5</numbering></numberingGroup><coverDate startDate="2003-10">October 2003</coverDate></publicationMeta><publicationMeta level="unit" type="caseStudy" position="0045500" status="forIssue"><doi origin="wiley">10.1034/j.1399-0012.2003.00005.x</doi><idGroup><id type="unit" value="CTR005"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1">Case Reports</title></titleGroup><eventGroup><event type="firstOnline" date="2003-09-17"></event><event type="publishedOnlineFinalForm" date="2003-09-17"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.5 mode:FullText source:FullText result:FullText" date="2010-04-07"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-16"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="455">455</numbering><numbering type="pageLast" number="460">460</numbering></numberingGroup><correspondenceTo>
Prof. Jean Michel Dubernard, Service de Chirurgie de la Transplantation, Hopital Edouard Herriot, 5 Place d'Arsonval, 69437 Lyon, France. Tel.: +33 4 7211 0584; fax: +33 4 7211 0581;
e‐mail: <email normalForm="jean-michel.dubernard@chu-lyon.fr">jean‐michel.dubernard@chu‐lyon.fr</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:CTR.CTR005.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Accepted for publication 26 April 2002</unparsedEditorialHistory><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="0"></count></countGroup><titleGroup><title type="main">First human double hand transplantation: efficacy of a conventional immunosuppressive protocol</title><title type="shortAuthors"><b>Petruzzo et al.</b></title><title type="short"><b>Immunosuppression in double hand graft</b></title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Palmina</givenNames><familyName>Petruzzo</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2" noteRef="#fn1"><personName><givenNames>Jean Pierre</givenNames><familyName>Revillard</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>Jean</givenNames><familyName>Kanitakis</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a4"><personName><givenNames>Marco</givenNames><familyName>Lanzetta</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a5"><personName><givenNames>Nadey S</givenNames><familyName>Hakim</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a6"><personName><givenNames>Nicole</givenNames><familyName>Lefrançois</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a7"><personName><givenNames>Earl</givenNames><familyName>Owen</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>Jean Michel</givenNames><familyName>Dubernard</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation> Service de Chirurgie de Transplantation,</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation> INSERM U503,</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="FR"><unparsedAffiliation>Service de Dermatologie Hôpital Edouard Herriot, Lyon, France,</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="IT"><unparsedAffiliation> Hand Surgery and Reconstructive Microsurgery San Gerardo Hospital, University of Milano Bicocca, Monza, Italy,</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="GB"><unparsedAffiliation> Transplantation Unit, St Mary's Hospital, London, UK,</unparsedAffiliation></affiliation><affiliation xml:id="a6" countryCode="FR"><unparsedAffiliation> Service de Médecine de Transplantation Hôpital Edouard Herriot, Lyon, France and</unparsedAffiliation></affiliation><affiliation xml:id="a7" countryCode="AU"><unparsedAffiliation> Microsearch Foundation of Australia and Outer Sydney Hand and Microsurgery Unit, Sydney, Australia</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">composite tissue allograft</keyword><keyword xml:id="k2">hand transplantation</keyword><keyword xml:id="k3">immunosuppression</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><!--
Petruzzo P, Revillard JP, Kanitakis J, Lanzetta M, Hakim N, Lefrançois N, Owen E, Dubernard JM. First human double hand transplantation: efficacy of a conventional immunosuppressive protocol.
Clin Transplant 2003: 17: 455–460. © Blackwell Munksgaard, 2003
--><p><b>Abstract:</b> Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33‐yr‐old man suffering from a traumatic amputation of both hands in 1996. Five HLA‐A, ‐B, and ‐DR mismatches were present with the donor; T and B cell cross‐match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti‐HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side‐effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft‐versus‐host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><label>*</label><p>
Prof Jean‐Pierre Revillard died on June 2, 2003 and the authors dedicate this manuscript to him.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>First human double hand transplantation: efficacy of a conventional immunosuppressive protocol</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Immunosuppression in double hand graft</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>First human double hand transplantation: efficacy of a conventional immunosuppressive protocol</title></titleInfo><name type="personal"><namePart type="given">Palmina</namePart><namePart type="family">Petruzzo</namePart><affiliation> Service de Chirurgie de Transplantation,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean Pierre</namePart><namePart type="family">Revillard</namePart><affiliation> INSERM U503,</affiliation><description>Prof Jean‐Pierre Revillard died on June 2, 2003 and the authors dedicate this manuscript to him.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean</namePart><namePart type="family">Kanitakis</namePart><affiliation>Service de Dermatologie Hôpital Edouard Herriot, Lyon, France,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marco</namePart><namePart type="family">Lanzetta</namePart><affiliation> Hand Surgery and Reconstructive Microsurgery San Gerardo Hospital, University of Milano Bicocca, Monza, Italy,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nadey S</namePart><namePart type="family">Hakim</namePart><affiliation> Transplantation Unit, St Mary's Hospital, London, UK,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nicole</namePart><namePart type="family">Lefrançois</namePart><affiliation> Service de Médecine de Transplantation Hôpital Edouard Herriot, Lyon, France and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Earl</namePart><namePart type="family">Owen</namePart><affiliation> Microsearch Foundation of Australia and Outer Sydney Hand and Microsurgery Unit, Sydney, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean Michel</namePart><namePart type="family">Dubernard</namePart><affiliation> Service de Chirurgie de Transplantation,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="case-report" displayLabel="caseStudy" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-29919SZJ-6">case-report</genre><originInfo><publisher>Munksgaard International Publishers</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2003-10</dateIssued><edition>Accepted for publication 26 April 2002</edition><copyrightDate encoding="w3cdtf">2003</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">3</extent><extent unit="tables">0</extent></physicalDescription><abstract>Abstract: Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressive protocol are evaluated. The recipient was a 33‐yr‐old man suffering from a traumatic amputation of both hands in 1996. Five HLA‐A, ‐B, and ‐DR mismatches were present with the donor; T and B cell cross‐match was negative. Immunosuppressive protocol included tacrolimus, prednisone, mycophenolate mofetil and, for induction, antithymocyte globulins and then anti CD25 monoclonal antibody. Reconstitution of lymphocyte populations proceeded normally. Neither anti‐HLA antibodies nor chimerism in peripheral blood were detected. Two episodes of acute rejection characterized by maculopapular lesions occurred on days 53 and 82 after transplantation. Skin biopsies revealed a dermal lymphocytic infiltrate. Both episodes were completely and rapidly reversed by topical clobetasol and increased systemic corticosteroid therapy. The only side‐effects related to treatment were reversible serum sickness and hyperglycemia. No infectious complications and malignancies occurred. No signs of graft‐versus‐host disease have been detected. This case of double hand transplantation shows that conventional immunosuppression is effective and safe to ensure survival and functional recovery of the grafted limb.</abstract><subject lang="en"><genre>keywords</genre><topic>composite tissue allograft</topic><topic>hand transplantation</topic><topic>immunosuppression</topic></subject><relatedItem type="host"><titleInfo><title>Clinical Transplantation</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0902-0063</identifier><identifier type="eISSN">1399-0012</identifier><identifier type="DOI">10.1111/(ISSN)1399-0012</identifier><identifier type="PublisherID">CTR</identifier><part><date>2003</date><detail type="volume"><caption>vol.</caption><number>17</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>455</start><end>460</end><total>6</total></extent></part></relatedItem><identifier type="istex">38A09461F6EF4A39CA0A645DFD108A01561DFC2F</identifier><identifier type="ark">ark:/67375/WNG-FJ7R4QJX-G</identifier><identifier type="DOI">10.1034/j.1399-0012.2003.00005.x</identifier><identifier type="ArticleID">CTR005</identifier><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource><recordOrigin>Munksgaard International Publishers</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/38A09461F6EF4A39CA0A645DFD108A01561DFC2F/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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