PROBLEMS OF CTA (HAND) PROCUREMENT – 5 YEAR EXPERIENCE

Adam Chelmonski¹, Zbigniew Sycz², Jerzy Jablecki¹.

¹Subdepartment of Replantation of Limbs, St Jadwiga Hosp, Trzebnica, Poland; ² Intensive Care Ward, 4th Military Hosp, Wroclaw, Poland.

Background: CTA being the youngest branch of transplantation present new challenges for this medical disciplineAs some changes in the body of the deceased donor will be detectable after recovery, CTA procurement procedure differs from that of internal organs, posing additional problems for the coordinator of transplantation. It is customary to make a request to the next –of –kin of a deceased for a limb donation, and receiving such a consent is a matter of experience and skilfulness of the transplantation coordinator. It is also important (especially in case of unilateral Tx) to ensure that the compatibility of size and cosmetic features between donor and future recipient does exists.

Method: We analyzed the hand donations and ways of decision-making during the 5-year period.

Results: Polish Hand Transplantation Program started in 2006 and since then is performed in only one center –Trzebnica.; 7 hand Tx were performed in 6 patients In the process of donor acquisition we cooperated with the National Center for Tissue Transplantation “Poltransplant”. During the past 5 years we received 16 donor notifications from 5 hospitals (Intensive Care Ward) and 10 of them were send from one particular center (4th Military Hospital in Wroclaw), 5 of such eventually led to a hand Tx (one donor was from our local hospital) Our program encountered 10 resignations, markedly 4 of which were on patients’ request, and the remainder due to blood-group incompatibility (3 cases), anatomical mismatch of limb (3) and one donor’s neoplasm (chorionepithelioma). We note that the intensive medial activity, popularizing the idea of the hand Tx resulting in social acceptance leads to significant increase in the number of potential recipients and donors, raising the possibility of the optimal selection of the transplanted organ.

Conclusion: As proved by the statistics the dedication of a coordinator for the and Tx program is a main factor for it’s effectiveness.